Characteristics of Vaccine-Hesitant and Nonhesitant Parents in Italy: A Cross-Sectional Study

Vaccine hesitancy remains a significant public health challenge, even in countries with high vaccination coverage, such as Italy. Understanding the sociodemographic, informational, and psychological characteristics associated with hesitancy is essential for designing effective, targeted interventions.

To describe and compare the sociodemographic, behavioral, informational, and psychological profiles of vaccine-hesitant and non-hesitant Italian parents.

A descriptive cross-sectional study was conducted between October 2024 and February 2025 using an anonymous online survey distributed through social media and parenting websites. Eligible participants were parents or legal guardians of children aged 0-18 years, residing in Italy. Vaccine hesitancy was assessed using the Parent Attitudes about Childhood Vaccines short form (PACV-5), alongside validated measures of health literacy (HLS-EU-Q6), vaccine literacy (HLVa-IT), adult vaccine hesitancy (aVHS), vaccine confidence (VCI), and parental health locus of control (PHLOC). Descriptive and bivariate analyses were performed to examine the differences between hesitant and nonhesitant parents.

Of the 308 participants, 13% were classified as vaccine-hesitant. Hesitancy was significantly associated with lower educational attainment, absence of a health care background, reliance on television and health assistants for vaccine information, lower health and vaccine literacy, lower vaccine confidence, and higher scores in the Fate subscale of the Chance domain and the Child subscale of the Internal domain of the Health Locus. A total of 89.94% of parents reported full adherence to vaccination schedules, yet hesitant parents were more likely to partially vaccinate their children and express selective vaccination intentions. Discrepancies between past vaccination behavior and future intentions were observed, suggesting that hesitancy is dynamic and potentially unstable.

Vaccine hesitancy among Italian parents is associated with low health literacy and confidence levels, distinct health beliefs, and specific information-seeking patterns. These findings suggest public health efforts should include trust-building approaches that address cognitive skills, fatalistic beliefs, and preferred communication channels. Longitudinal research is necessary to monitor changes in parental attitudes and to guide adaptive intervention strategies.