Impact of mandatory law on vaccine hesitancy spectrum: The case of measles vaccine catch-up activities in Tuscany, Italy

The policy was adopted, as part of the national response to a large outbreak of measles, to contrast the decline of vaccine coverage (VC). Since 2014, in fact, VC have decreased, leading to reduced level of protection in Italian population, in particular for measles, mumps and rubella vaccine (measles VC at 24-month of age was 90.4% in 2013, then ranging between 85.3% and 87.3% in the years 2014–2016) [3,4]. While changes in attitude towards vaccination and vaccine hesitancy are key indicators worth monitoring alongside vaccine coverage, there are other significant outcomes of the mandatory law that are less easy to assess. Since the mandatory law became effective in 2017, regional and local health authorities in Tuscany and elsewhere in the country, have embarked in systematic review and validation of their rIIS, to verify entries, cleaning databases and entering missing information. [...]more children have completed the recommended vaccination schedule, and health authorities can rely on their monitoring systems to assess the impact of the interventions and to better plan for future initiatives.