Paediatric activities and adherence to vaccinations during the COVID-19 epidemic period in Tuscany, Italy: A survey of paediatricians

Introduction. The global COVID-19 pandemic is placing a heavy burden on health services. One result could be a general reduction in routine vaccination activities. In Tuscany (Central Italy), paediatricians (in agreement with the regional health service) administer and register paediatric vaccinations of their patients. The aim of the present study was to evaluate the impact of the COVID-19 epidemic on paediatric vaccinations administered by Tuscan paediatricians, as a proxy of adherence to vaccinations during this epidemic period. Methods. Four hundred members of the Tuscany section of the Italian Federation of Paediatricians (FIMP) were invited to participate in a semi-structured online survey. Results. During the COVID-19 pandemic, almost all (98.2%) of the 223 respondents reported a general decline in outpatient paediatric visits; 65.8% reported a more than 60% reduction (144 answers) in comparison with the situation before the COVID-19 pandemic. A total of 208 paediatricians (93.3%) continued to vaccinate in the period considered: 66/208 (31.7%) reported a reduction in parents' compliance with mandatory vaccination (hexavalent and MMRV vaccines), and 88/208 (42.3%) reported a reduction in compliance with non-mandatory vaccinations. Almost all paediatricians declared having taken preventive actions to counter the spread of SARS-CoV-2. Discussion and conclusions. Although the majority of Tuscan paediatricians continued to vaccinate during the lock-down, some parents decided to postpone their children's scheduled vaccinations, mainly owing to fears concerning the safety of access to health services. When Italian immunization coverage data on the first months of 2020 become available, it will be possible to assess the real impact of the COVID-19 pandemic on paediatric vaccinations. It is crucial to continue vaccinating against preventable infectious diseases in order to avoid other possible epidemic outbreaks. The pandemic must not be seen as an obstacle to compliance with the vaccination schedule, but rather as an excellent opportunity to underline the importance of all recommended vaccinations.