Parental vaccination to reduce measles immunity gaps in Italy

Measles is one of the world’s most contagious diseases causing thousands of deaths every year, despite a safe and effective vaccine being available since the 1960s. High rates of vaccination – about 95% of each age group – are required to eliminate measles, but national and global health agencies struggle to achieve high vaccination rates because some parents were and still are hesitant to vaccinate their children. As a result, large measles epidemics continue to occur even in countries with well-established vaccination programs. In Italy, low vaccination rates year after year have resulted in large numbers of unprotected youth and adults. The country has recently introduced mandatory measles vaccination at school entry to improve vaccination coverage among children. Yet a high proportion of measles cases in Italy continue to occur in people over 20 years old, a situation that could be improved by immunization programs targeting adults. One approach would be to take advantage of the compulsory vaccination of children by offering parents the vaccine at the same time. Marziano et al. used computer modeling to estimate how various vaccination scenarios would affect measles spread in Italy. Their models showed that current vaccination policies targeting school age children would be unlikely to eliminate measles before 2045. On the other hand, if 50% of parents were also vaccinated, elimination could be achieved by 2042, and as early as 2031 if 99% of parents agreed to vaccination. Marziano et al. show that a parental vaccination campaign could reduce the population of adults susceptible to measles in Italy and help the country stop the spread of the disease. However, more research is needed to assess how feasible and sustainable this policy would be. Additional policies to increase vaccination against measles in adults could also help, but parental vaccination has a key advantage: it does not require active targeting to recruit parents, since they are already immunizing their children.