Parental trust and beliefs following 6 years of improper vaccinations in Northern Italy

Background: Between 2009 and 2015, in a health district of North Eastern Italy 5444 children were not vaccinated properly, posing a threat to herd immunity maintenance. An extraordinary vaccination campaign was implemented in the at risk cohort and, for those not answering to the first 2 active calls, a telephone survey was conducted during the third wave of calls to investigate parental confidence levels and trusted information sources on vaccines. Methods: A trained medical student interviewed parents about vaccines and trusted sources of information between December 2017 and February 2018 through a standardized questionnaire of 12 items by phone. Parental educational level and age were also collected. Answers were stratified and compared using Chi-square test, with an α-level of 0.05. Results: 382 families out of 770 (50%) were reached at the phone for the vaccination campaign and 258 (68%) participated in our survey. Family pediatricians (27%), general practitioners (25%) and health professionals (19%) turned out to be the most trusted sources of information. Answers did not significantly differ by parental age. Parents with low educational level trusted friends (11%) and TV (9%) more than other educational levels (p < 0.0001), while higher education was associated with scientific literature searching and institutional website access. Even if 80% of parents believe that vaccination is a fundamental practice, doubts about efficacy emerged for 47% of total respondents and for 58% of parents with a degree (p < 0.05). Worries about side effects concerned lowly educated parents (38%) more than others (p < 0.05). Conclusions: A considerable proportion of families targeted by this step of the extraordinary vaccination campaign was contacted successfully. Health professionals resulted to be trusted sources for most parents irrespective of the underlying improper vaccination issue. Highly educated parents often rise doubts about vaccines and look for information independently. Key messages: Trust toward health professionals has not been undermined by this episode of improper vaccination. An in-depth study of information source selection among differently educated parents is relevant to deal with vaccine hesitancy.