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Abstract

Background: In our country immunization rates have shown regress in recent years from 94% in 2008-2009 to 75% in 2017-2018 according to Albania Demographic and Health Survey 2017-2018. This decline in immunization rates has led to Measles epidemics we have seen in the last decade. The “Vaccine hesitancy” phenomenon is becoming a concern in our country and is highly contributing to the decrease in the immunization rates.

Objectives: We intend to find out what are the major concerns of parents who immunize their children. Another goal is to explore the reasons why parents delay or refuse immunization of their children in the first 5 years of life. Finally, we want to find common concerns between parents who do immunize and those who delay or refuse it. Study Design and Methods: Anonymous confidential questionnaires were given to 1206 random parents in public and private health centers all over Albania from October to December 2018. Parents expressed their concerns in regards of vaccines received by children from 0-5 years old according to the Albanian Immunization calendar.

Results: From our statistical analysis was concluded that 95.19% (1148) of parents have some type of safety concern, trust issue, side effects and source of vaccine supply concern. 38% (403) of parents who immunize their children are concerned about“There are too many vaccines given at the same time”. Almost all of them, 34% (357), despite their concerns, immunize their children because “Pediatrician advised them” and/or “Immunizations are mandatory for daycare/ school admissions”. In regards to parents who delay or refuse immunization, 58% of them were concerned about Autism (p-value = 5.94e-79 < 0.05). Results show that 44.04% (48) of parents who delay or refuse immunization, make this decision based on only 1(one) of the following concerns “Vaccines are not safe” (Chi square calculated p value = 8.47e-20 < 0.05), “I do not trust vaccines overall” (p value = 1.98e-15 < 0.05), “Too many vaccines given at the same time”(p value = 0.003), “I do not have enough information” (p value = 1.51e-07 < 0.05). Another important new concern we found to be statistically significant is “I do not trust the effectiveness of State Vaccines“(15.38 %), Chi-Square calculated p-value = 4.42e-05 <0.05.

Conclusions: There is significant evidence that parents concerns are real and we, as health care professionals, must address these concerns and take measures to improve them. We believe that if parents are convinced that state vaccines have good quality, they will be more prone to immunize their children in time and ultimately decrease Measles and other infectious diseases outbreaks in our region. We can address the issue of “Too many vaccines given at the same time” by creating a new immunization schedule that requires fewer vaccines to be given at one time. This approach will help parents to wilfully immunize their children, not because they are “mandatory by law”. It is important to invest in giving them more information about vaccines quality and safety, so parents will understand why MMR does not cause Autism. Most of all it is crucial to resolve their trust issues and safety concerns. This task will require more research and collaboration between healthcare professionals and pharmaceutical companies to improve the quality of vaccines.

Biography

Ledia Qatipi has completed her Medical School in 1999 from University of Medicine, Tirana, Albania and postgraduate studies in Internal Medicine and Pediatrics from Staten Island University Hospital, New York, USA. Currently she works as Senior MD at ABC Health Center, part of ABC Heath Foundation, a non profit organization Tirana, Albania, that gives affordable medical care to the urban and rural communities and underserved children. She also served for 10 years as a Quality Improvement Committe Board member of BCCHC (Beacon Christian Community Health Center, Staten Island, New York). She has published more than 10 papers in reputed journals in USA and Europe.