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The impact of a school-based multicomponent intervention for promoting vaccine uptake in Italian adolescents: a retrospective cohort study.

BACKGROUND
In Italy, the National Immunization Prevention Plan recommends for adolescents between ages 11 and 18 several vaccines, however their adherence is below the expected coverage. School-based delivery strategies might represent an alternative to primary care settings. This study aims to evaluate the impact of a school-based intervention aimed to increase the vaccination uptake among Italian secondary class students.


METHODS
One of the four schools in which a school-based multicomponent intervention was previously carried out has been matched with a control school in the same geographical area. Students' coverage for mandatory and recommended vaccinations was assessed before and after an 8 months period using the Local Health Authority Immunization Register.


RESULTS
Seven hundred and fifty-five resident students in the RM Local Health Authority were included: 265 from the intervention school, 490 from the control school. At baseline, the two schools were comparable for grades and sex distribution; the intervention school had significant higher immunization rates for Meningococcal B, but lower ones for the 4th dose of dTap. After eight months, higher percentage of students received the HPV (30.5% vs 13.8% of females; p = 0.003) Meningococcal C (6.0% vs 2.0%; p = 0.005) and Meningococcal B (14.7% vs 0.3%; p <0.001) vaccines in the intervention school compared with control. The pre-post differences between the two schools in the immunization rates were significantly higher in the intervention school for the HPV, Meningococcal C and B vaccines.


CONCLUSIONS
This study demonstrates that a school-based health promotion project was effective in improving the recommended vaccines uptake among adolescents with potential interesting implication for the national target attainment. Considering the importance of informing and educating, innovative school-based health promotion programs could represent an excellent opportunity for the Local Health Authorities to get in touch with a hard-to-reach target. Performance in offering the vaccination in school facilities should be evaluated.