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Volume 14
Issue 4
10.18683/germs.2024.1446
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GERMS is published by MDPI from Volume 25 Issue 4 (2025). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with the former publisher Infection Science Forum S.R.L..
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Article

Segmenting Attitudes Toward Vaccination—Behavioral Insights into Influenza Vaccination Refusal in Romania

by
Gheorghe Gindrovel Dumitra
1,2,
Sandra Adalgiza Alexiu
2,
Dorica Sănduţu
2,
Cosmina Berbecel
2,
Monica Curelea
2,
Cristina Vasilica Barbu
2,
Anca Deleanu
2,
Adrian Grom
2,
Maria Lup
2,
Ioana Budiu
2,
Mădălina Vesa
2,
Roxana Surugiu
3,*,
Anca Lăcătuş
2,* and
Adina Turcu-Stiolica
4
1
Family Medicine Department, University of Medicine and Pharmacy of Craiova, 2-4 Petru Rares Street, 200349 Craiova, Romania
2
Immunization Working Group, Romanian National Society of Family Medicine, 65, Popa Nan Street, Bucharest, Romania
3
Department of Biochemistry, University of Medicine, and Pharmacy of Craiova, 2 Petru Rares Street, 200349 Craiova, Romania
4
Pharmacoeconomics Department, University of Medicine and Pharmacy of Craiova, 2-4 Petru Rares Street, 200349 Craiova, Romania
*
Authors to whom correspondence should be addressed.
GERMS 2024, 14(4), 362-374; https://doi.org/10.18683/germs.2024.1446
Submission received: 9 December 2024 / Revised: 31 December 2024 / Accepted: 31 December 2024 / Published: 31 December 2024
Versions Notes

Abstract

Introduction: Vaccine hesitancy remains a significant public health challenge, particularly in rural populations where geographic and socioeconomic barriers exacerbate the issue. This study aimed to examine the factors influencing vaccine hesitancy, focusing on influenza vaccinations in rural and urban communities in Romania. Methods: The study was conducted between October 4 and October 30, 2024, across 16 family medicine practices, including seven in rural and nine in urban areas from Romania. A 13-item vaccine hesitancy questionnaire, assessing factors such as fear of adverse effects, distrust in vaccines, and perceived necessity included 272 responses. Latent Class Analysis (LCA) was used to identify distinct subgroups of hesitancy, while Chi-square and odds ratio analyses assessed geographic differences. We performed logistic regression for the most observed root attitudes on influenza vaccination refusal. Results: Rural residents were significantly more likely to refuse influenza vaccination compared to urban residents. The LCA revealed three distinct latent classes, characterized by varying levels of agreement with key hesitancy items. Class 1 demonstrated low hesitancy, Class 2 exhibited high hesitancy driven by beliefs in natural immunity and perceived lack of necessity, and Class 3 showed intermediate hesitancy, influenced by distrust in vaccines and past negative experiences. Among the key significant triggers underlying vaccine refusal were fear of adverse effects, parental status, chronic diseases, and previous vaccination experiences, while factors such as age and gender showed limited impact. Conclusions: Vaccine hesitancy persists as a complex, multidimensional issue, with rural populations disproportionately affected. Targeted, context-specific interventions addressing key drivers such as distorted risk perception, fear of adverse effects and distrust in vaccines are critical for improving vaccination rates These findings underscore the importance of tailored public health strategies to promote equitable vaccine uptake.
Keywords: vaccine hesitancy; influenza vaccine; flu; Romania; vaccine refusal vaccine hesitancy; influenza vaccine; flu; Romania; vaccine refusal

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MDPI and ACS Style

Dumitra, G.G.; Alexiu, S.A.; Sănduţu, D.; Berbecel, C.; Curelea, M.; Barbu, C.V.; Deleanu, A.; Grom, A.; Lup, M.; Budiu, I.; et al. Segmenting Attitudes Toward Vaccination—Behavioral Insights into Influenza Vaccination Refusal in Romania. GERMS 2024, 14, 362-374. https://doi.org/10.18683/germs.2024.1446

AMA Style

Dumitra GG, Alexiu SA, Sănduţu D, Berbecel C, Curelea M, Barbu CV, Deleanu A, Grom A, Lup M, Budiu I, et al. Segmenting Attitudes Toward Vaccination—Behavioral Insights into Influenza Vaccination Refusal in Romania. GERMS. 2024; 14(4):362-374. https://doi.org/10.18683/germs.2024.1446

Chicago/Turabian Style

Dumitra, Gheorghe Gindrovel, Sandra Adalgiza Alexiu, Dorica Sănduţu, Cosmina Berbecel, Monica Curelea, Cristina Vasilica Barbu, Anca Deleanu, Adrian Grom, Maria Lup, Ioana Budiu, and et al. 2024. "Segmenting Attitudes Toward Vaccination—Behavioral Insights into Influenza Vaccination Refusal in Romania" GERMS 14, no. 4: 362-374. https://doi.org/10.18683/germs.2024.1446

APA Style

Dumitra, G. G., Alexiu, S. A., Sănduţu, D., Berbecel, C., Curelea, M., Barbu, C. V., Deleanu, A., Grom, A., Lup, M., Budiu, I., Vesa, M., Surugiu, R., Lăcătuş, A., & Turcu-Stiolica, A. (2024). Segmenting Attitudes Toward Vaccination—Behavioral Insights into Influenza Vaccination Refusal in Romania. GERMS, 14(4), 362-374. https://doi.org/10.18683/germs.2024.1446

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