Measles vaccine in the school settings: a cross-sectional study about knowledge, personal beliefs, attitudes and practices of schoolteachers in northern Italy

BACKGROUND: School teachers (STs) might have a crucial role in countering students' and parents' hesitancy towards immunization. Such role is associated with STs own knowledge, attitudes and practices (KAP) towards vaccines. In this cross-sectional study we assess measles vaccine KAP in a sample of Italian STs. METHODS: Between January 2012 and August 2015, 376 STs from the Lombardy region were enrolled in the study; data were retrieved on socio-demographic characteristics, KAP towards MeV, including immunization status. The association between knowledge, practices and a favorable attitude towards MeV was assessed calculating Odds Ratio (OR) and respective 95% confidence intervals (95% CIs) through multivariate regression analysis. RESULTS: 16.7% of STs in Italy know national recommendations on MeV and 16.0% were favorable to MeV and 12.8% of STs reported to have been vaccinated against MeV as adults and only 5.9% reported fears of MeV side effects (e.g. autisms). MeV propensity was associated with previous vaccination as adults (OR=5.222; 95% CI: 1.752-15.567), knowledge of national recommendations, and the understanding that MeV prevents natural infection and disease transmission (OR=2.274; 95% CI: 1.246-4.149, OR=14.061; 95% CI: 7.048-28.063, and OR=2.085; 95% CI: 1.125-3.864, respectively). CONCLUSIONS: The share of STs holding false beliefs and misconceptions towards MeV was lower than expected. STs might actively contribute to fight parents' vaccine hesitancy and such social role should be further acknowledged and promoted by policy makers and the wider public health community.