Are Italian adolescents fully protected against vaccine-preventable diseases?

Introduction

Vaccination is a key public health strategy for protecting against vaccine-preventable diseases (VPDs) across the life course, including adolescence. In Italy adolescents are offered several vaccinations against HPV, meningococcal diseases, diphtheria, tetanus, pertussis and poliomyelitis. Nonetheless, evidence on their full vaccination status and determinants are scant. This study assessed the vaccination status of adolescents residing in Umbria Region, Italy, and explored associated socio-demographic and cultural factors.

Methods

A cross-sectional study was conducted in the 2024/2025 school year among 12-year-old adolescents and their parents in Umbria, using a web-based questionnaire administered through lower secondary schools. Collected data included vaccination status and potential determinants, either socio-demographic and socio-cultural ones, namely health literacy, vaccine hesitancy, and cultural affiliation, all assessed with validated instruments.

Results

Among 277 adolescents who responded to the questionnaire, 79,9% (95% CI:74,5%–84,3%) were fully vaccinated against all the VPDs for which vaccination is recommended in adolescence. Full vaccination was significantly associated with higher parental and adolescents’ HPV knowledge. Interestingly, adolescents’ health literacy was associated to vaccination status with those with an active/partially active attitude towards one’s health being more likely fully vaccinated in respect to passive ones (81% vs 40%). The other variables did not show any association with full vaccination status.

Conclusions

The findings showed missed opportunities in adolescents’ vaccination and a significant role of attitudes towards own’s health and both parents’ and adolescents’ knowledge. Interventions targeting health literacy and knowledge of VPDs may improve adolescents’ protection.

Key messages

• Adolescents are a sensitive target for vaccination and show missed opportunities for being fully protected against vaccine-preventable diseases.

• Parents’ and adolescents’ knowledge as well as adolescents’ health literacy may influence the uptake of all the vaccines recommended in adolescents.