Understanding parental influences on adolescents’ vaccination in Italy

Parents play a pivotal role in vaccination decision-making during adolescence. This cross-sectional survey aimed to assess parents’ knowledge, attitudes, and behaviors regarding recommended adolescent vaccinations and to identify the factors associated. The survey was conducted between April and December 2025 among a random sample of parents with a child attending public middle and high schools in Naples and Salerno, Italy. A total of 503 parents participated. More than half (53.7%) correctly identified all three recommended vaccinations for adolescents (Tdap, MenACWY, HPV), and awareness was highest for the HPV vaccine (81.9%), followed by Tdap (72.8%) and MenACWY (72.3%). Multivariate logistic regression analyses showed that participants who had received information about adolescent vaccinations from healthcare workers (HCWs) or institutional websites were three times more likely to correctly identify them. Less than one-third (30.9%) considered vaccinations very useful and 17% reported being very concerned about their safety. Nearly two-thirds (63.8%) were highly vaccine hesitant. Higher levels of hesitancy were associated with not knowing the recommended vaccinations for adolescents, having a lower education, and not considering important for schools to organize educational interventions on recommended adolescent vaccinations. More than one-third (37.3%) reported that their child had received all three recommended vaccinations. Parents were more likely to have vaccinated their child if they had received information from HCWs or institutional websites and were aware of the recommended vaccinations for adolescents. Less than two-thirds (60%) of parents whose children had not been vaccinated expressed willingness to vaccinate their child against Tdap and HPV, one-third (36%) against MenACWY, and 20.2% reported an intention to administer all the missing one(s). Public health strategies aimed at strengthening communication, enhancing vaccine education, and promoting school-based interventions are needed for improving coverage of vaccinations.