Determinants of Parental Attitudes towards Children's Vaccination in Lithuania: An Online Survey.

Background: Data from recent years show that the COVID-19 pandemic has significantly reduced the scope of child immunisation worldwide. If the numbers continue to fall, we may have a vaccination crisis. In order to understand the local factors of this phenomenon, we studied parents' viewpoint towards childhood vaccination in Lithuania. Therefore, the aim of our study was to determine the impact of parental attitudes on children's vaccination. Materials and Methods: A web-based cross-sectional study was made in Lithuania from October 20th to November 3rd, 2020, using Google Forms. An anonymous questionnaire included both quantitative and qualitative questions. The questionnaire was distributed to the general population in Lithuania via social media and a snowball sampling. Only parents who have at least one child under 18 years old were involved in the study. We analysed the parents' attitudes towards vaccination by their socioeconomic and demographic determinants using MS Excel and OpenEpi tools. The respondents were considered vaccine supporters if they vaccinated all their children with state-reimbursed vaccines or only vaccinated some of their children, and vaccine sceptics if they did not vaccinate their children with state-reimbursed vaccines. Results: The population of our research consisted of 775 parents. There were more males against vaccination than females, respectively, 59.6% and 33.2%. 65.0% of all respondents stated that they vaccinated their children with the full course of vaccines, while the remaining 35.0% did not vaccinate. University-level education dominated in both pro-vaccine and anti-vaccine groups. We found that 16.9% of parents who were unvaccinated as children themselves tend not to vaccinate their children. However, in the pro-vaxx group, only 0.7% of parents were unvaccinated during childhood. 50.8% of vaccine sceptics were not fully informed by healthcare professionals about the benefits and risks of vaccination, while only 31.6% of vaccine supporters were not informed. Social environment did not have an impact on the decision whether to vaccinate or not to vaccinate a child among both vaccine advocates and vaccine deniers (accordingly, 51.2% and 42.9%). 29.3% of respondents stated that the cost of paid vaccinations was too high. Open-text survey responses gave us more in-depth insight about the parental decision-making process. Protection of children and society from infectious diseases (31.7%) was mentioned as the main reason for vaccination. Whereas vaccine-hesitant parents were mostly concerned about already-occurring side effects or their risk (43.4%). Conclusions: Our findings confirmed that vaccine hesitancy was associated with not being vaccinated in childhood themselves, lack of information from medical practitioners and male gender. The price of vaccines also had an impact on immunisation rates - more than one-third of the vaccine supporting parents indicated that the cost of paid vaccinations was too high. The main incentive for vaccine compliance was parents' desire to protect their children and society from infectious diseases. Whereas vaccine-hesitant parents were mostly concerned about already occurring side effects or their risk. There was no consensus, whether vaccination of children should be mandatory in Lithuania, as the answers to the question were almost evenly distributed. The formation of parents' attitudes towards children's vaccination is a complex process that is determined by parents' attitudes towards the health care system, lack of trust in doctors, and gaps in communication about the benefits and risks of vaccination. All of this information should be taken into account in health policy-making.

SARS-CoV-2 Seroprevalence in Lithuania: Results of National Population Survey.

SUMMARY BACKGROUND: Betacoronavirus SARS-CoV-2 has spread in early 2020 worldwide just in several months. The official statistics are consistently collected, but this is mainly based on symptomatic reports. This study was aimed to estimate the seroprevalence of SARS-CoV-2 infection in Lithuanian population. MATERIALS AND METHODS: Study was conducted during August-September 2020 in 6 municipalities of Lithuania. The sample comprised 3087 adult participants from the general population (mean age 53.7 years, 64% female). SARS-CoV-2 antibodies were assessed using AMP IgM/IgG Rapid Test, other data were based on self-report. Seroprevalence was assessed as a crude estimate and as adjusted by sensitivity-specificity of the test. RESULTS: The crude seroprevalence in the total sample was 1.9%, the adjusted - 1.4%, ranging from 0.8% to 2.4% across municipalities. Among seroprevalent cases, 67.2% had IgG, 29.3% had IgM, and 3.5% had both IgG and IgM. An increased risk for seropositive test was observed among people who reported having had close contacts with SARS-CoV-2 positives (OR=5.49, p<0.001). At the borderline significance were female gender (OR=1.75, p=0.082) and non-smoking status (OR=2.95, p=0.072). Among the seropositive participants, 69.0% reported having had no COVID-19 symptoms since 1 March 2020, while 31.0% reported having had at least one of the symptoms. CONCLUSIONS: The SARS-CoV-2 seroprevalence in Lithuanian sample in August-September 2020 was 1.4%, ranging from 0.8% to 2.4% across municipalities. Given the overall official data, by the end of study (11 September 2020) the total COVID-19 rate in Lithuania was 117.5 per 100,000 population or 0.12%. This suggests more than 10 times higher prevalence of virus across the population than the official estimates.

Health of Roma children in Vilnius and Ventspils.

According to the literature data, Roma health and living conditions in Central and Eastern Europe are poorer than of the rest of population. However, the more detailed information about Roma health is lacking. The aim of the study was to evaluate morbidity, health self-assessment, and prevalence of addictions among Roma children in Vilnius and Ventspils and to compare with health indicators of non-Roma children. PARTICIPANTS AND METHODS. A descriptive epidemiological study was carried out, anonymously questioning all volunteer Roma children - 59 in Vilnius (Lithuania) and 31 in Ventspils (Latvia) schools. Results were compared with identical study, carried out in five Vilnius schools (reference group, 640). RESULTS. The appliance rate of Roma children to doctor did not differ from reference group - half of all questioned children visited doctor 1-3 times during the last year. However, more Roma children (74.6% from Vilnius and 64.6% from Ventspils) considered their health as poor and very poor as compared to reference group (4.3%). The proportion of children indicating somatic symptoms often and very often did not differ statistically significantly among groups with exception of vomiting and nausea, which was most prevalent among Vilnius Roma and Ventspils Roma. The proportion of children indicating emotional symptoms often and very often differed significantly in all groups and was the biggest in Ventspils Roma group. The proportion of daily alcohol, drug users, and smokers was higher in Vilnius Roma and Ventspils Roma groups, although the differences among all three groups were not statistically significant. CONCLUSION. Although the morbidity of Vilnius Roma and Ventspils Roma groups did not differ from reference group, essential discrepancy was found in health self-assessment - more Roma children considered their health as poor and very poor.

Self-medication with antibiotics in Lithuania.

OBJECTIVES: Excessive and not always proper use of antibiotic give rise to numerous problems, of which antimicrobial resistance, currently cause for worldwide concern, is the major one. Few single studies of antibiotic use have been carried out in some countries. This study was performed to estimate the prevalence of antibiotic use in the general population of Lithuania with special interest in self-medication with antibiotics and sources of their acquisition. MATERIALS AND METHODS: Structured questionnaires on antibiotic use during the last 12 months were mailed to randomly selected adults and 746 of them were finally analyzed. RESULTS: It was found that 39.9% of respondents reported antibiotic use during the last 12 months preceding the study and 53.2% of those used them in self-medication. In general, 22.0% (95%CI: 19.1-25.1) of respondents used antibiotics without prescription, whereas 45.0% (95%CI: 41.3-48.7) of them used antibiotics for intended self-administration. Adjustment for all the factors revealed the impact of the occupation, place of residence and presence of chronic disease on self-medication with antibiotics. Representatives of managerial, executive and professional occupations used non-prescribed antibiotics 8.38 times more often (95% CI: 1.76-39.91, p = 0.01) than retired people. Healthy people showed the tendency to self-medication 2.04 times more frequently than those with chronic diseases (95%CI: 1.11-3.75, p = 0.02). Rural people used non-prescribed antibiotics 1.79 times more often than inhabitants of urban areas (95%CI: 1.00-3.18, p = 0.049). Community pharmacies proved to be the most frequent (86.0%) source of over-the-counter antibiotics. Tonsillitis, bronchitis, and upper respiratory infections were the major reasons for self-medication with antibiotics. CONCLUSIONS: The high prevalence of self-medication with antibiotics was found in Lithuania. The study indicated the need for more strict control of antibiotic sales and promotion of education of the correct use of antibiotic among Lithuanian people.