A review of childhood rotavirus vaccination policies and a presentation of vaccine coverage trends at national and regional level, Italy, 2016 to 2023

BACKGROUNDRotavirus is a main gastroenteritis cause in children ≤ 5 years old. In 2017, when few Italian regions had rotavirus vaccination programmes, rotavirus vaccines were included in the National Plan for Preventive Vaccination (PNPV). Although all Italian regions follow the PNPV, they each decide how to implement it, contributing to rotavirus vaccination coverage differences across the country.AIMThe objective was to assess rotavirus vaccination national/regional policies in Italy and, between 2016 and 2023, vaccination coverage trends at national and regional level.METHODSScientific and grey literature was systematically reviewed for reports on Italian national/regional policies or programmes concerning rotavirus vaccination. Their key features and strategies to increase vaccination coverage were recorded. Vaccination coverage data originating from the Ministry of Health, were analysed descriptively, or with linear regression, for national and regional trends.RESULTSAmong 418 policy/programme reports identified, 25 were included. Between 2013 and 2015, Sicilia, Calabria and Puglia had already initiated universal vaccination programmes. The PNPV 2017-19 standardised regions' offer of rotavirus vaccination. Between 2016 and 2023, vaccination coverage in Italy significantly increased (p = 0.0005) from 10.5% to 70.76%, with a 140% rise in 2019-20. Regional coverage disparities existed. Throughout 2016-23, most central Italian regions had annual coverages below national values. Bolzano annual coverage was consistently < 50%, while in Veneto, coverage reached 85.10% in 2021. In 2023, five regions had > 80% coverage.CONCLUSIONSWhile rotavirus vaccination coverage improved in Italy in 2016-23, regional disparities persist. Addressing these requires overcoming logistical and societal challenges, as well as harmonised policies.