Who chooses alternative sources of information about childhood vaccinations? A cross-sectional study.

Introduction: Vaccine hesitancy can lead to problematic outcomes in terms of public health. A factor playing a fundamental role in this dynamic is the source of information considered by parents in the decision-making progress that leads to the acceptance or refusal of childhood vaccinations. This study aims to investigate the sources of information considered by the parents of children attending primary and secondary schools in two large Italian cities and to identify predictors that led to choosing alternative sources of information. Methods: An online questionnaire was administered to the parents of students attending elementary, middle, and high schools in Rome and Turin. Two validated tools were used: the Parent Attitudes about Childhood Vaccines Survey and the Vaccine Health Literacy of adults in Italian. Sources of information about vaccinations, trust toward the healthcare system, hesitancy and attitudes about COVID-19 vaccinations, were also investigated. A multivariable logistic regression model was built to identify predictors of the preferred sources of information on the topic. Results: Totally, 2,301 answers to the survey were collected from June to October 2021. Of these, 1,127 came from parents in Rome (49%) and 1,174 from parents based in Turin (51%) with a mean age of 47.7 years (±6.4). The majority of the respondents were mothers (81%), married (73%), with two or more children (70.5%). The multivariable logistic regression model results showed that fathers were more inclined than mothers to use alternative sources of information (OR 1.48, 95% CI 1.29-2.00). Moreover, a higher level of vaccine hesitancy was a strong predictor for choosing alternative sources of information (OR 2.45, 95% CI 1.73-3.46). The HLVa-it scores show that parents with a lower Vaccine Literacy (VL) were more inclined to use alternative sources of information. Discussion: Addressing health literacy issues and changing the official forms of communication could help improving vaccine acceptance. This study shows the importance of rebuilding a trusting relationship between patients and health care providers, which is fundamental in the fight against vaccine hesitancy.

The tattooed population in Italy: a national survey on demography, characteristics and perception of health risks.

BACKGROUND: In recent years, Italy has seen a constant upward trend in the practice of tattooing. The Italian National Health Institute has conducted a national survey to determine the prevalence of tattooed people in Italy and to study related features of the phenomenon. AIM: Establish the prevalence and characteristics of the tattooed population and evaluate awareness of the risks associated with tattoos, which can contribute to consumer health protection. METHODS: Computer-assisted telephone interviews and computer-assisted web interviews were completed by a sample of the general population; 7608 people aged between 12 and 75+. RESULTS: The prevalence of tattooed people was 12.8% of the general population in Italy (95% CI: 12.05%-13.55%), equivalent to an estimated 6 900 000 tattooed individuals. Tattoos were more prevalent among women, at 13.8%, while tattooed men accounted for 11.8%. The vast majority of tattooed subjects had decorative tattoos of small dimensions, with a higher prevalence of monochromatic tattoos. Only a minority of tattooed participants reported having cosmetic tattoos (3.0%) or medical tattoos (0.5%). According to the data, 3.3% of tattooed subjects claimed complications or reactions; of these, only 21.3% consulted a dermatologist/general practitioner; more than half (51.3%) did not consult anyone. In general, only 58.2% of the sample were aware of health risks. The Italian survey showed that 36.7% of all tattoos had been performed in the last five years prior to the interview. CONCLUSIONS: The estimated prevalence of tattoos in Italy is in agreement with the statistics of the European Union. The prevalence in the age group 35-44 years is almost double that of the Italian population and it is higher in women than in men. Tattooing is relevant to public health. The high number of tattooed Italians, the potential long-term effects on health and the reported complications call for the awareness of health authorities. Appropriate intervention should ensure safer tattooing by reinforcing the training of tattooists, by improving surveillance and by providing information to raise public awareness of the risks and contraindications of tattooing.

Implementation of European Council resolution ResAP(2008)1 in Italy. National and regional regulation of tattoo practices: diversity and challenges.

In Italy, tattoos and permanent make-up have become increasingly popular in recent years. The number of tattoo parlours has increased from 257 in 2009 to 2,055 in 2014, wich is a eight-fold increase over the last 6 years. Although there is no specific legislation, the Italian Ministry of Health issued a document containing the 'Guidelines for the implementation of procedures for tattooing and piercing in safe conditions'. This document has not been adopted by all Italian regions, principally regarding training course requirements for tattoo professionals, creating a highly fragmented situation that resembles the European scene in miniature. ResAP(2008)1, which is not mandatory in Italy but was made binding by Italian Decree n. 206/2005, has been applied uniformly throughout the country. Thus, as far as the safety of inks is concerned, the surveillance system appears to be working well. However, surveillance has highlighted the presence of non-compliant inks and potentially unsafe preparations for tattoo removal in the market. Updating and rebalancing the situation will be the goal in order to face the challenge of combining well-being with the on-going social demand of looking after and beautifying the body. This would include the growing fashion of tattoos, provided that the products that are used are safe and that tattooing is performed in controlled hygienic conditions that fully guarantee the health of consumers.

Rapid methods for identification of poliovirus isolates and determination of polio neutralizing antibody titers in human sera.

A new rapid method for identification and determination of the titer of polioviruses and other enteroviruses in cell monolayers grown in microtiter plates is described. The method is based on immunoperoxidase staining of infected cells with commercial monoclonal antibodies (MAb) and biotin-labeled secondary antibody. The presence of poliovirus or other enteroviruses was established as the appearance of at least one focus of cells with stained cytoplasm 6 h post-infection. Viral titers determined by this method were expressed as focus forming unit (FFU) per ml which was found to correspond approximately to 10 TCID(50)/ml. The suitability of this technique to determine poliovirus antibody titers in human sera was also tested comparing the immunocytochemical neutralization assay with a conventional neutralization in microtiter plates. The test was standardized using reference human sera in order to produce antibody titers expressed in international units (IU). In addition to high reproducibility, the new neutralization test appears to be sensitive, specific and rapid, and might thus represent a useful tool for the diagnosis of polio and other enterovirus infections.