Elsevier

Vaccine

Volume 28, Issue 35, 9 August 2010, Pages 5731-5737
Vaccine

Tracking parental attitudes on vaccination across European countries: The Vaccine Safety, Attitudes, Training and Communication Project (VACSATC)

https://doi.org/10.1016/j.vaccine.2010.06.009Get rights and content

Abstract

The paper presents the first results from the European project VACSATC which aimed to track parental attitudes on vaccinations across several European countries. We compared five cross-sectional surveys of parents with children less than 3 years of age in England, Norway, Poland, Spain and Sweden carried out during 2008–2009. Data were collected from 6611 respondents. Two countries used face-to face interviews, one used telephone interviews, and two other countries used mail-in questionnaires. In all countries health professionals were indicated as the most important and trusted source of information on vaccination. The study results also show that parental attitudes on vaccinations in the childhood vaccination programs are generally positive. However, there were differences in attitudes on vaccination between the five countries, possibly reflecting different methods of sampling the respondents, context-specific differences (e.g. level of activity of governmental agencies), but also individual-level parental variation in demographic and socioeconomic status variables.

Introduction

Carrying out surveys to track parental attitudes on the vaccination of their children is important in order to identify barriers which may lead to suboptimal vaccination coverage. A survey supplements surveillance data and vaccination coverage assessments, and allows early detection of the reasons why some parents do not vaccinate their children. Attitudinal studies have been performed in several countries [1], [2], [3], [4]. Several studies have also addressed factors driving the decision to be vaccinated [5], [6], [7], [8].

Few countries run routine attitudinal surveys, and no common methodology has been agreed between governmental health agencies. The recent situation concerning A(H1N1) vaccinations against swine flu revealed public apathy or outright opposition towards vaccination in some countries [9]. The important public health prevention tool of vaccination can become ineffective if not widely accepted. To address health education to the public, we first need to understand what people already know about vaccines and the vaccine-preventable diseases, and what more they want to know and their opinion of the health services offered. Information has to be tailored to the public level of knowledge about diseases and the benefits and possible adverse events following vaccination. Furthermore, the form and language used in information materials to the public may need to be tailored to particular ethnic minorities or ‘hard to reach’ groups.

Within the framework of the project Vaccine Safety – Attitudes, Training, Communication (VACSATC) funded by a grant from the Directorate General for Health and Consumer Affairs (DG SANCO) [10], a group of vaccination experts representing mostly public health institutions in 14 countries, has agreed on a common thematic approach to monitor attitudes on vaccinations. In each country a survey was performed during the years 2007–2009, using a list of at least 10 questions based on the core themes agreed between the partners. The list was adapted from the Department of Health attitudinal surveys that have been performed annually in England since 1991 [3], [11]. In 5 countries the surveys were performed during 2008–2009 in large samples of parents with children aged 0–3 years. Results from the Polish survey have been published in Polish [4]. Detailed results from the other VACSATC surveys are expected to be published in their local language as well as in English.

The objective of this paper was to summarize the surveys performed in England, Norway, Poland, Spain and Sweden, in order to assess the possibility to develop a standard tool that could be applied in diverse geographical and cultural settings. We used the comparison of the survey results to discuss the methodological challenges, and assess selected indicators of vaccination perceptions.

Section snippets

Materials and methods

The data used in the analysis come from surveys of caregivers or parents to 0–3-year-old children in England, Norway, Poland, Spain and Sweden. Methods of sample selection in the five surveys are summarized in Table 1.

In England the survey was performed during October–November 2008 through a subcontracted social research company TNS-BMRB. A random location sampling technique assured representativeness of the sample compared to the age, socioeconomic status and geography of the overall

Results

A total of 6611 interviews were collected in the five countries from May 2008 until December 2009. The basic demographic information of the interviewed parents is presented in Table 2. Sweden and Norway differ from the other countries in the proportion of parents >35 years of age, fathers responding to the survey, parents with university education and parents with 2 or more children. The response rate ranged from around 40% in Norway and Sweden to 77% in Poland and 98% in Spain. The response

Discussion

Few studies have previously addressed the role of attitudes in vaccine uptake at a European level [6], [12], [13]. The general aim of the VACSATC collaboration was to fill this gap in the literature on attitudes on childhood vaccinations. The more specific aim of the VACSATC collaboration was twofold. The first aim was to develop a comprehensive common questionnaire on parental attitudes on vaccinations to be used by all members of the consortium. The second aim was to agree on a common mode of

Conclusions

The 2009 A(H1N1) influenza pandemic clearly showed that even when equipped with an excellent prevention tool, public health authorities cannot use vaccines efficiently without public acceptance. This in turn requires good communication channels to disseminate the reasons for mass vaccination, explanations that vaccination is safe and carefully monitored, and convincing information that the disease poses a threat to individuals and to the society. To communicate efficiently, public health

Funding

This study was funded by the DG SANCO grant no. 2005212 (VACSATC – Vaccine Safety: Attitudes, Training, Communication) and by project partners.

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