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Qualitative Assessment of Vaccine Hesitancy in Romania

1
Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
2
Department of Microbiology, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
3
Department of Medical Education, Division of Medical Informatics and Biostatistics, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Medicina 2019, 55(6), 282; https://doi.org/10.3390/medicina55060282
Received: 29 April 2019 / Revised: 12 June 2019 / Accepted: 14 June 2019 / Published: 17 June 2019
(This article belongs to the Special Issue Promoting Vaccine Acceptance)
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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. View Full-Text
Keywords: vaccine hesitancy; vaccine acceptance; MMR; HPV; qualitative thematic analysis; influence of media; measles outbreak vaccine hesitancy; vaccine acceptance; MMR; HPV; qualitative thematic analysis; influence of media; measles outbreak
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Miko, D.; Costache, C.; Colosi, H.A.; Neculicioiu, V.; Colosi, I.A. Qualitative Assessment of Vaccine Hesitancy in Romania. Medicina 2019, 55, 282.

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