Description:
<jats:title>Abstract</jats:title>
<jats:sec>
<jats:title>Background</jats:title>
<jats:p>Lombardy is Italy's most affluent and most populated region, with the highest national per capita GDP, and over 10 million residents - more than 16 out of 27 EU countries. In 2017, two measures were approved against vaccine hesitancy, i.e. the National Plan for Vaccine Prevention (2017-2019) and Law no. 119 on mandatory vaccinations. Aim of the study is to monitor Lombardy regional-level vaccine coverage trends and to assess the new legislative framework's overall impact.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Methods</jats:title>
<jats:p>We analysed and critically interpreted Lombardy regional-level vaccination coverage (2000-2018 for childhood vaccinations; birth cohorts 1997-2005 for HPV; flu seasons 1999-2000/2018-2019 for influenza). All data were extracted from the Italian Ministry of Health website. We carried out descriptive trend analysis for measles and polio-containing vaccines in 24 month-old-children, Human Papilloma Virus vaccine in 12-year-old females, and influenza vaccine in seniors over 65 years. Regional data were compared with the corresponding Italian national averages.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Results</jats:title>
<jats:p>Childhood vaccinations: Lombardy and Italy have never met the 95% target for measles-containing vaccines (average coverage 2000-2018: Lombardy 91,79%, Italy 86,94%). Polio-containing vaccines have always remained above the 95% threshold, with a drop in 2015-2017. In 2018 they increased back to safety levels (Lombardy 95,31%, Italy 95,09%). HPV: coverage has always kept below WHO/SAGE intermediate 80% goal (average coverage, birth cohorts 1997-2005: Lombardy 75,58%, Italy 72,73%). Influenza: mean coverage has been alarmingly inadequate (Lombardy 54,09%, Italy 57,98%) compared to WHO-recommended minimum of 75%.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Conclusions</jats:title>
<jats:p>Except for influenza, coverage in Lombardy is slightly higher than the Italian average. Exploring Lombardy's response to the national legislation could guide policymakers in developing tailored vaccination strategies.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Key messages</jats:title>
<jats:p>Overall, vaccination coverage in Lombardy is slightly higher than the Italian average. In 2017, law n.119 on mandatory vaccinations came into force, acting as a powerful tool for coverage increase.</jats:p>
</jats:sec>