Qualitative Assessment of Vaccine Hesitancy in Romania

Abstract

Background and objectives: Health systems all over the world are confronted with an alarming rise of cases in which individuals hesitate, delay, and even refuse vaccination, despite availability of quality vaccine services. In order to mitigate and combat this phenomenon, which are now defined by the World Health Organization (WHO) as vaccine hesitancy (VH), we must first understand the factors that lead to its occurrence in an era characterized by wide access to safe and effective vaccines. To achieve this, we conducted field testing of the Vaccine Hesitancy Scale (VHS), as it was developed by the Strategic Advisory Group of Experts Working Group (SAGE WG), in Cluj-Napoca city, Cluj County, Romania. The scale is designed to quantify VH prevalence in a population, establish which vaccines generate the highest percentage of hesitancy, and allow a qualitative assessment of the individual’s reasons for hesitance. Materials and Methods: We conducted an observational cross-sectional survey, which was comprised of descriptive, analytical, and qualitative elements regarding VH. The necessary sample size was 452 individuals. The VHS and Matrix of Determinants (recommended by SAGE WG) for reasons people gave to justify their hesitance, was interpreted by qualitative thematic analysis (QTA) to ensure the validity and reliability in detecting hesitancy across various cultural settings and permit global comparisons. Results: We found a VH of 30.3% and 11.7% of parents reported refusing to vaccinate their child. Among the VH responders, the varicella vaccine generated 35% hesitancy, measles vaccine 27.7%, Human Papillomavirus (HPV) 24.1%, and mumps vaccine 23.4%, respectively. The QTA values for percent agreement ranged from 91% to 100%. Cohen’s Kappa values ranged from 0.45 to 0.95. Contextual influences identified for VH were "media," "leaders and lobbies," and "perception of the pharmaceutical industry." Individual and group influences for VH were "beliefs," "knowledge," and "risk/benefits (perceived).” Vaccine and vaccination specific issues for VH were "risk/benefit (rational)" and "health care practitioners (trustworthiness, competence).” Conclusions: One-third of the investigated population had expressed VH, and a further one-third of these had refused a vaccine for their child. Chicken Pox, Measles, Mumps, Rubella (MMR), and HPV vaccines generated the most hesitation. Negative information from the media was the most frequently evoked reason for VH.

HPV vaccine hesitancy among parents in Italy: a cross-sectional study

“…14 A higher result of 48% has been observed in France in a sample of parents of girls aged 11-15 years 21 whereas a lower value of 24.1% was found among parents and/or guardians in Romania. 22 The hesitancy was significantly more common among unmarried parents', less knowledgeable, those who did not believe that the vaccination was useful for the prevention of HPV-related cancers, and who wished to receive more information about this vaccination. The finding that those hesitant were less knowledgeable about HPV is not surprising because one would expect that those non-hesitant would have received at least basic information about the virus and the vaccine.…”

Assessment of Vaccine Hesitancy to a COVID-19 Vaccine in Cameroonian Adults and Its Global Implication

“…After preliminary training, the two researchers identified 3697 statements that are directly linked to at least one of the 21 items. The binary methody (item present in the statement: 1/item absent from the statement: 0) was then used tothen independently mapped the 3697 statements directly against the 21 items of the Matrix, as previously reported [ 25 ].…”

Prevalence of Parental refusal rate and its associated factors in routine immunization by using WHO Vaccine Hesitancy tool: A Cross sectional study at district Bannu, KP, Pakistan

“…The problem is prevalent both in developing and developed countries alike. In Romania, 11.7% of parents refuse to vaccinate their children (Miko et al 2019) and in Malaysia, vaccine refusal rate is almost 18.2% (Lim et al J o u r n a l P r e -p r o o f 5 2016b).Similarly, in developed countries like UK and USA, a continuous decrease in coverage of Measles, Mumps and Rubella (MMR) vaccine is observed recently. Globally, somewhat similar trends have been observed resulting in 30% rise in measles cases; a diseases that has already been eradicated from the world in 2000(The Lancet Child & Adolescent Health 2019).…”