TeamVax Italy and the Italian Charter for the promotion of immunization

Parents, healthcare workers, bloggers and science communicators have launched a positive experience in Italy, with the aim of sharing and promoting scientific information towards an important public health goal: to face the drop in vaccine coverage. In fact, despite the active efforts of the public health system, vaccine hesitancy is a constantly growing issue. In October 2015, the alliance between different stakeholders gave rise to a movement called TeamVax Italy that, at the beginning of 2016, developed the Italian Charter for the promotion of immunization. The Charter is an advocacy tool, a call for action that offers the opportunity to support and defend the importance of vaccination programmes to whoever wants to be committed. Moreover, it is also a tool that can be used by all the institutions and the people involved to raise awareness among decision makers at local, regional and national level.

Six are the principles that the Charter enforces: right to prevention, social responsibility, information, fight against disinformation, communication, quality. Each of these principles go with specific actions, for a total of 45, which must satisfy some requirements. For instance, the possibility to identify a responsible subject, the action feasibility, its institutional acceptability, its potential impact. In order to facilitate the use of the Charter, several potential scenarios have been proposed, based on the role of individual or institution involved. Thus, there are specific actions for public health organisations, for citizens, for educational bodies, for journalists and bloggers.

However, the most important and innovative aspect is that the Charter represents a place where requests and necessities from both parents and healthcare workers come together. Motions advanced by parents involved in the preparation of the document underwent a careful evaluation from TeamVax. In particular, some themes that mostly concern parents have been discussed and then reworked into specific actions, such as:

  • the necessity of acquiring transparent, clear and accessible information (Actions 3.1, 3.4, 3.8, 3.9, 3.10, 3.11);
  • the necessary response from institutions either to the new communicative scenario and to the new composition of hesitant parents (Actions 5.1, 5.2, 5.4, 5.7);
  • the quality of vaccination services and the support for parents in terms of reception, education and proper assistance (Actions 6.2, 6.3, 6.4, 6.5, 6.7, 6.8).

The first draft of the document – resulted from a collaborative approach and an internal discussion between members of the team – was followed by a technical evaluation phase. Actions and principles stated in the Charter underwent an analysis by national experts, group members and vaccine commissions  of the Regions Puglia, Marche, Toscana and Veneto (in Italy, public health management is structured on a regional level). Comments and advices gathered through this process were then further analysed and discussed, in order to modify and approve the final version of the document. The Charter was then presented and promoted through public events, press releases, televised reports and, obviously, online platforms and TeamVax members’ social accounts. It is possible to download the document, subscribe to it and examine its main signers on the dedicated website.

The initiative had an immediate success: in July 2016, the Charter had almost 1,000 subscriptions, distributed as follows:

Citizens (32.1%)
Healthcare workers (30%)
Students (12.8%)
Health companies (2.7%)
Bloggers/debunkers (3.1%)
Professors/researchers (4%)
Schools/Universities (1.1%)
Scientific societies (1.6%)
Journalists (1.5%)
Others (10.4%)

In the same period, the website had more than 12,500 views and 5,400 active sessions, with a 77% rate of new sessions. The most interesting figure certainly is the bounce rate at 49%, which means that those who visit the website tend to extend their visit before signing the Charter or leaving, and navigate through different pages, thus allowing TeamVax to achieve their objective: to spread grounded information on its activity.

The Charter already obtained relevant institutional subscriptions like Regions, faculties of Medicine, provincial Orders of physicians, Italian municipalities, all the main scientific societies involved on this topic, as well as the approval by the Minister of Health, which was committed to giving the most support possible to this initiative. This experience thus represents a solid and effective example of online communication that supports a social mobilisation towards the protection of public health, as well as a successful way to connect all the relevant stakeholder – institutions, citizens, healthcare workers, students – in an active and collaborative process. A process that strengthen both the sense of social responsibility and the trust bond with institutions.

Daniel Fiacchini, Sara Letardi, Alice Pignatti
On behalf of TeamVax Italy


Larson HJ, Jarrett C, Eckersberger E, Smith D, Paterson P. Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: A systematic review of published literature, 2007–2012. Vaccine, Volume 32, Issue 19, Pages 2150-2159.
MacDonald NE, the SAGE Working Group on Vaccine Hesitancy. Vaccine hesitancy: Definition, scope and determinants. Vaccine 33 (2015) 4161-4164.
Suk JE, Lopalco P, Pastore Celentano L. Hesitancy, Trust and Individualism in Vaccination Decision­Making. PLOS Currents Outbreaks. 2015 Feb 25. Edition 1.
European Centre for Disease Prevention and Control.  Let’s talk about protection. Stockholm: ECDC; 2016.
European Centre for Disease Prevention and Control.  Let’s talk about hesitancy. Stockholm: ECDC; 2016.

MMLAP and other EU Projects

Health system analysis to support capacity development in response to the threat of pandemic influenza in Asia
Making society an active participant in water adaptation to global change
Public Participation in Developing a Common Framework for Assessment and Management of Sustainable Innovation
Engaging all of Europe in shaping a desirable and sustainable future
Expect the unexpected and know how to respond
Driving innovation in crisis management for European resilience
Effective communication in outbreak management: development of an evidence-based tool for Europe
Solutions to improve CBRNe resilience
Network for Communicable Disease Control in Southern Europe and Mediterranean Countries
Developing the framework for an epidemic forecast infrastructure
Strengthening of the national surveillance system for communicable diseases
Surveillance of vaccine preventable hepatitis
European monitoring of excess mortality for public health action
European network for highly infectious disease
Dedicated surveillance network for surveillance and control of vaccine preventable diseases in the EU
Modelling the spread of pandemic influenza and strategies for its containment and mitigation
Cost-effectiveness assessment of european influenza human pandemic alert and response strategies
Bridging the gap between science, stakeholders and policy makers
Promotion of immunization for health professionals in Europe
Towards inclusive research programming for sustainable food innovations
Addressing chronic diseases and healthy ageing across the life cycle
Medical ecosystem – personalized event-based surveillance
Studying the many and varied economic, social, legal and ethical aspects of the recent developments on the Internet, and their consequences for the individual and society at large
Get involved in the responsible marine research and innovation
Knowledge-based policy-making on issues involving science, technology and innovation, mainly based upon the practices in Parliamentary Technology Assessment
Assessment of the current pandemic preparedness and response tools, systems and practice at national, EU and global level in priority areas
Analysis of innovative public engagement tools and instruments for dynamic governance in the field of Science in Society
Public Engagement with Research And Research Engagement with Society
Computing Veracity – the Fourth Challenge of Big Data
Providing infrastructure, co-ordination and integration of existing clinical research networks on epidemics and pandemics
Promote vaccinations among migrant population in Europe
Creating mechanisms for effectively tackling the scientific and technology related challenges faced by society
Improve the quality of indoor air, keeping it free from radon
Improving respect of ethics principles and laws in research and innovation, in line with the evolution of technologies and societal concerns
Investigating how cities in the West securitise against global pandemics
Creating a structured dialogue and mutual learning with citizens and urban actors by setting up National Networks in 10 countries across Europe
Identifying how children can be change agents in the Science and Society relationship
Establishing an open dialogue between stakeholders concerning synthetic biology’s potential benefits and risks
Transparent communication in Epidemics: Learning Lessons from experience, delivering effective Messages, providing Evidence