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

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