DETERMINANTS OF VACCINE HESITANCY AMONG PARENTS IN KYIV.

OBJECTIVE: The aim: Assess of the determinants of vaccine hesitancy among parents regarding their children in Kyiv, Ukraine. PATIENTS AND METHODS: Materials and methods: Direct interview with survey on parents' attitudes and behaviors regarding their children's immunization. Vaccination hesitancy was determined with the median of responses and by self-reported question. The study was conducted among parents, whose children were patients at Children's hospitals, attend schools and kindergarten in Kyiv, Ukraine. RESULTS: Results: The median of vaccine hesitancy was 14,2% of 797 parents in Kyiv. The results show that 81.5% of parents with university degree agree that vaccination of their child is important for the health of others in the community, whereas only 67% (p≤0.05) of people who graduated from high school supported this view. The only reason to vaccinate their child is so they can enter daycare or school was marked by only 4.5% of parents with university education background and 15.3% of people who graduated from high school (p≤0,05). CONCLUSION: Conclusions: Vast majority of interviewed parents think that vaccines are important for their children; meanwhile only half of the parents fully trust the current National Immunization Schedule and fully agree that question of child vaccination is their responsibility. Consulting pediatricians and GPs are associated with more parental confidence than other medical workers. Main source of negative information about vaccines is the Internet, but some part of parents who received negative information indicates health care workers as a source of this information. Majority of parents thinks that their religion is compatible with vaccines.

Access to Vaccination among Disadvantaged, Isolated and Difficult-to-Reach Communities in the WHO European Region: A Systematic Review.

Vaccination has a significant impact on morbidity and mortality. High vaccination coverage rates are required to achieve herd protection against vaccine-preventable diseases. However, limited vaccine access and hesitancy among specific communities represent significant obstacles to this goal. This review provides an overview of critical factors associated with vaccination among disadvantaged groups in World Health Organisation European countries. Initial searches yielded 18,109 publications from four databases, and 104 studies from 19 out of 53 countries reporting 22 vaccine-preventable diseases were included. Nine groups representing the populations of interest were identified, and most of the studies focused on asylum seekers, refugees, migrants and deprived communities. Recall of previous vaccinations received was poor, and serology was conducted in some cases to confirm protection for those who received prior vaccinations. Vaccination coverage was lower among study populations compared to the general population or national average. Factors that influenced uptake, which presented differently at different population levels, included health service accessibility, language and vaccine literacy, including risk perception, disease severity and vaccination benefits. Strategies that could be implemented in vaccination policy and programs were also identified. Overall, interventions specific to target communities are vital to improving uptake. More innovative strategies need to be deployed to improve vaccination coverage among disadvantaged groups.

Vaccine confidence among parents: Large scale study in eighteen European countries.

BACKGROUND: Despite the fact that vaccines save 2-3 million lives worldwide every year, a percentage of children are not getting appropriately vaccinated, thus leading to disease outbreaks. One of the major reasons of low vaccine uptake in Europe is vaccine hesitancy, contributing to the recent measles outbreaks. Monitoring of vaccine hesitancy is valuable in early identification of vaccine concerns. METHODS: We performed an eighteen country European survey on parents' attitudes and behaviors regarding their children's immunization. Parents having at least one child 1-4 years old were mostly recruited by primary care paediatricians to reply to a web-based questionnaire. The questionnaire was developed by the European Academy of Paediatrics Research in Ambulatory Setting Network steering committee, based on similar surveys. An individual level hesitancy score was constructed using the answers to 21 questions, and correlations of the score with socio-demographic characteristics and types of providers were explored. To assess inter country differences, a country level self -reported confidence was defined. RESULTS: Fifty six percent and 24% of 5736 respondents defined themselves as "not at all hesitant", and "somewhat hesitant", respectively. Parents who consulted general practitioners were more hesitant than parents who consulted pediatricians (p < 0.05). Consultation with homeopathists was associated with the highest reported hesitancy (p < 0.05). Vaccine confidence was highest in Portugal and Cyprus, and lowest in Bulgaria and Poland. CONCLUSION: The majority of parents in Europe believe in the importance of childhood vaccination. However, significant lack of confidence was found in certain European countries, highlighting the need for continuous monitoring, awareness and response plans. The possible influence of different types of healthcare providers on parental decisions demonstrated for the first time in our survey, calls for further research. Monitoring and continuous medical education efforts aimed mostly at those professionals who might not be likely to recommend vaccination are suggested.