Inaction, under-reaction action and incapacity: communication breakdown in Italy’s vaccination governance

Katie Attwell (), Tauel Harper, Marco Rizzi, Jeannette Taylor, Virginia Casigliani, Filippo Quattrone and PierLuigi Lopalco
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Katie Attwell: University of Western Australia
Tauel Harper: University of Western Australia
Marco Rizzi: University of Western Australia
Jeannette Taylor: University of Western Australia
Virginia Casigliani: University of Pisa
Filippo Quattrone: University of Pisa
PierLuigi Lopalco: University of Pisa

Policy Sciences, 2021, vol. 54, issue 3, No 1, 457-475

Abstract: Abstract This article explores why governments do not respond to public compliance problems in a timely manner with appropriate instruments, and the consequences of their failure to do so. Utilising a case study of Italian vaccination policy, the article considers counterfactuals and the challenges of governing health policy in an age of disinformation. It counterposes two methods of governing vaccination compliance: discipline, which uses public institutions to inculcate the population with favourable attitudes and practices, and modulation, which uses access to public institutions as a form of control. The Italian government ineffectively employed discipline for a number of years. Epistemological and organisational constraints stymied its efforts to tackle a significant childhood vaccination compliance problem. With a loss of control over the information environment, vaccinations were not served well by exogenous crises, the sensationalism of the news cycle and online misinformation. Hampered by austerity, lack of capacity and epistemic shortcomings, the Italian government did not protect the public legitimacy of the vaccination programme. Instead of employing communications to reassure a hesitant population, they focused on systemic and delivery issues, until it was too late to do anything except make vaccinations mandatory (using modulation). The apparent short-term success of this measure in generating population compliance does not foreclose the need for ongoing governance of vaccine confidence through effective discipline. This is evident for the COVID-19 vaccination campaign, with many Italians still indicating that they would not accept a vaccine despite the devastation that the disease has wrought throughout their country.

Keywords: Vaccination policy; Mandatory vaccination; Policy governance; Government inaction (search for similar items in EconPapers)
Date: 2021
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Citations: View citations in EconPapers (3)

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DOI: 10.1007/s11077-021-09427-1

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