Vaccines, a question of trust. Good care pays off in prevention

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(IlSole24Ore-Radiocor Plus) -If healthcare spending is destined to grow and, on the contrary, resources to reduce and, moreover, with an aging population, to avoid the perfect storm of Italian healthcare (and not only) prevention becomes no longer postponable. But prevention is the result of trust built over time. This is the lesson that comes from the vaccination campaign against covid-19. Together the largest scientific but also sociological experiment in the health sector on a global level.

Vaccines among the most cost-effective programs

More than fear could trust, one might say looking at the data of the study published by Rosanna Tarricone, Associate Dean of SDA Bocconi, together with an international team that involved 14 countries with different incomes, healthcare facilities and populations. From Italy to the United Kingdom, passing through Ethiopia, the United States or Mexico, the common factor among those who have chosen to get vaccinated, even beyond the obligations imposed by the different countries, is trust. “The decision to receive a vaccine is influenced by experience with the quality of healthcare. The greater the positivity of the experience, the greater the propensity to get vaccinated”, explains Rosanna Tarricone.
Looking only at Italy, the survey, conducted among those who also received two boosters after the first two doses, finds that the certainty of receiving adequate care in case of need reaches 63.9%. A much higher percentage, 48.8% than the United Kingdom or 57.7% in the United States, where the propensity for the vaccine was lower than here. Thus, on the contrary, there was the least confidence in vaccines, globally, among women, those with low education and those living in rural areas. Yet, Tarricone explains further, “vaccines and screening are among the most cost-effective public health programs.”

Only two out of ten Italians promote the NHS

But in reality, the objectives are far from being achieved. In the 2022-23 season only 20.2% of the general population and 56.7% of elderly people were vaccinated against influenza, numbers that are far from the 75% coverage target set by the Ministry of Health. Of course, before the pandemic, in the 2018-19 season, the general rate stopped at 15.8% and 53.1% among the elderly. But the recovery was little compared to the objectives.
“Excluding the anti-Covid vaccination, characterized by particularly strict restrictions for those who have not received it, we ask ourselves what drives citizens to hesitate in protecting their health”, says Tarricone again. The answer would be trust. “The tension in the health system and in the government increases the chances of vaccination, even beyond national obligations, while dissatisfaction with health services or negative experiences reduces these chances,” he explains.
And Italy does not seem to be doing very well, given that, again according to the numbers coming from Sda Bocconi, just two out of ten Italians evaluate the health service as very good or excellent, lower in the rankings even compared to African countries and most part of Asian and South American nations. «Even more worryingly, only 13.1% express optimism about the improvement of the healthcare system. These results seriously require attention, and require a serious debate that prompts a discussion on the elements necessary to re-establish a relationship of trust with the population, at the basis of the future sustainability of the national health service”, says Tarricone.

Vaccines declining in much of Europe
A topic on which much of Europe is wondering. “In our common goal of ensuring healthier and safer lives for current and future generations, it is imperative that vaccination remains a cornerstone of public health,” said Stella Kyriakides, Commissioner for Health and Food Safety, in World Health Week of Immunization marking 50 years since the introduction of the expanded immunization programme, speaking together with WHO representatives. In 1974 only 5% of children in the world had been vaccinated against diphtheria, tetanus and whooping cough. Today this figure has risen to almost 85% of children worldwide and 94% in the WHO European Region.
«While we celebrate these monumental achievements, which have protected the health of multiple generations, in the wake of the Covid-19 pandemic the decline in vaccination rates in some countries in the European region between 2020 and 2022 highlights the vulnerability of our success . Over the past three years, more than 1.8 million children have not been vaccinated against measles. The consequence of this is a 60-fold increase in the number of cases in 2023 compared to 2022. Our determination to ensure the benefits of vaccination for everyone, everywhere must not waver,” says Commissioner Kyriakides.
Building a healthcare system that works and gathers trust, could be the lesson that emerges from the Sda Bocconi study, is the best way to use it less. With the protection, first and foremost, of lives and, at the same time, of economic resources.