Management of vaccinations in Italy: a national survey after healthcare regionalization.

OBJECTIVES: The main aim of this study was to describe the effects of regional organization and performance in managing vaccinations- in the light of the institutional devolution recently introduced in Italy. METHODS: We analysed (1) the general organization of regions for vaccination programmes- (2) the management of four vaccination programmes (combined measles-rubella-parotitis- varicella for children- influenza- and pneumococcal 23-valent for adults). First- we conducted preliminary face-to-face interviews with 16 regional managers of the infective disease prevention departments. Subsequently- we sent them a standardized questionnaire to obtain comparable information on general organization and on the four specific vaccination programmes considered. In all- 14 regions were eventually included. RESULTS: The survey showed a widespread lack of regional staff involved in the management of vaccinations and a geographical variation in the availability of computerized data collection. We recorded poor coverage f