32 | Voter turnout and vaccination coverage: is there an association?

Background. Voter turnout is considered an indicator of civic engagement, whereas adherence to vaccination programs may reflect the level of trust in public health institutions. The aim of this study was to assess the association between voter turnout and vaccination coverage across Italian regions.

Materials and Methods. Voter turnout data were obtained from the Italian Ministry of the Interior's Eligendo platform, considering the referendum held on March 22–23, 2026. Vaccination coverage data were analyzed for the 2022 birth cohort, evaluating 24-month coverage rates for the third dose of the hexavalent vaccine and the first dose of the Measles-Mumps-Rubella (MMR) vaccine. Data were extracted from the website of the Italian Ministry of Health. A national-level analysis was conducted to assess the correlation between vaccination coverage and voter turnout.

Results. Voter turnout showed a clear North–South geographical gradient, with higher participation rates in northern regions and lower rates in southern regions. Vaccination coverage rates for both vaccines displayed a similar North–South divide. MMR vaccine coverage exhibited only limited geographical variability. Comparison of the variables revealed a tendency toward higher vaccination coverage in regions with greater electoral participation, a relationship that was more pronounced for the hexavalent vaccine.

Conclusions. The findings suggest an association between voter turnout and vaccine uptake. Analysis of regions with lower electoral participation showed a consistent pattern of lower vaccination coverage for both the hexavalent and MMR vaccines, further supporting this hypothesis. With the exception of a few regions characterized by a more heterogeneous distribution (such as Marche and Molise), these data suggest the existence of socio-cultural determinants that may influence both civic participation and adherence to vaccination programs.