PARENTS’ ATTITUDES TOWARDS VACCINATION OF THEIR OWN CHILDREN: EXPERIENCE FROM TWO PEDIATRIC CLINICS OF THE ZAGREB-WEST HEALTH CENTER

Neki roditelji nisu skloni cijepljenju vlastite djece što je rezultiralo padom stope procijepljenosti djece čime je ozbiljno ugrožena razina kolektivnog imuniteta u Hrvatskoj. Stoga je cilj ovog rada bio ispitati stavove roditelja prema cijepljenju vlastite djece te čimbenike koji na njih utječu. Istraživanje je provedeno u dvije pedijatrijske ambulante Doma zdravlja Zagreb – Zapad u kojemu su sudjelovali roditelji koji su dovodili djecu na cijepljenje ili redovite preglede. Za ispitivanje je korišten anonimni upitnik koji je sadržavao 26 pitanja: prvi dio upitnika sadržavao je pitanja o demografskim i socioekonomskim obilježjima ispitanika, a drugi dio odnosio se na stavove roditelja prema cijepljenju vlastite djece koji su procijenjeni uz pomoć Likertove ljestvice. Dobiveni rezultati statistički su obrađeni korištenjem statističkog programa SPSS 21 (IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.) uz metode deskriptivne i inferencijske statistike. U istraživanju je sudjelovalo 120 roditelja od kojih je 80 (66,7 %) bilo ženskog spola. Većina (90 %) roditelja cijepi svoju djecu redovito, 6,7 % roditelja zabrinuto je zbog cijepljenja djece i nema jasan stav o zakonskoj obvezi cijepljenja djece, a samo se jedan (0,8 %) roditelj izričito protivi obveznom cijepljenju djece. Kada bi imali pravo izbora, 37 (30,8 %) roditelja bi i dalje cijepili svoju djecu, dok bi čak 76 (63,3 %) roditelja odbilo cijepiti svoje dijete. Kao najčešći razlog zbog kojeg bi roditelji odbili cijepiti svoje dijete navodi se strah od nuspojava (52,5 % roditelja). Postoji statistički značajna razlika u stavovima o cijepljenju između ispitanika s obzirom na spol ispitanika i broj djece u obitelji: pozitivniji stav o cijepljenju imaju očevi (p=0,036) te roditelji koji imaju više djece (p=0,000). Kao izvor informacija o cijepljenju 102 (85 %) ispitanika je navelo nadležnog liječnika, a 66 (55 %) medicinsku sestru. U procjeni zadovoljstva roditelja s dobivenim informacijama o cijepljenju pokazalo se da je 42 (35 %) roditelja nezadovoljno informacijama o cijepljenju koje su dobili od nadležnog liječnika i medicinske sestre. Nedostatno informiranje roditelja dovodi do njihove pretjerane zabrinutosti, osobito glede nuspojava cjepiva, što ponekad može rezultirati donošenjem neadekvatnih odluka o cijepljenju. Iako većina naših roditelja ima pozitivan stav prema cijepljenju i u vrlo visokom postotku ispunjavaju obvezu redovnog cijepljenja vlastite djece, potrebno je uložiti dodatne napore u educiranje javnosti o cijepljenju. Zdravstveni djelatnici, osobito prvostupnice i magistre sestrinstva, mogle bi imati veću ulogu u educiranju roditelja o važnosti cijepljenja, njegovoj učinkovitosti i sigurnosti, s ciljem podizanja i održavanja visokih stopa procijepljenosti djece u Hrvatskoj.Aim: Vaccination proved to be one of the most effective and safe healthcare interventions, which has significantly reduced the morbidity and mortality of many infectious diseases. However, some parents are not willing to have their children vaccinated, and the parents\u27 negative attitudes towards vaccination have resulted in a declined vaccination coverage rate. Therefore, the level of collective immunity has been severely compromised, primarily among pre-school children. The aim of this study was to examine parents\u27 attitudes towards vaccination of their own children and to determine factors that influence development of these attitudes. Methods: The study was conducted in two pediatric clinics of the Zagreb-West Health Center and included parents having brought their children for vaccination or regular examinations. Participants were asked to complete an anonymous questionnaire containing 26 questions used to evaluate the parents\u27 attitudes towards vaccination of their own children. The first part contained questions on demographic and socioeconomic characteristics. The second part contained Likert scale for assessment of the parents\u27 attitudes. The results obtained were statistically analyzed using the SPSS 21 statistical software (IBM SPSS Statistics for Windows, Version 21.0, Armonk, NY, IBM Corp.) and descriptive and inferential statistics methods. Results: The study included 120 parents, 80 (66.7%) of whom were women. The majority (90%) of parents vaccinated their children regularly, 6.7% were concerned about vaccination and had no clear view of the legal obligation to vaccinate children, and only one (0.8%) parent explicitly opposed mandatory vaccination. If they had the right to choose, 37 (30.8%) parents would still vaccinate their children, whereas 76 (63.3%) would refuse to do so. As many as 63 (52.5%) parents stated fear of side effects as the most common reason why they would refuse to vaccinate their child. There was a statistically significant difference in the parents\u27 attitudes towards vaccination according to participant gender and number of children: fathers (p=0.036) showed more positive attitude towards vaccination, as well as parents with more children (p=0.000). No statistically significant difference was found in the participants\u27 attitudes towards vaccination according to their age, marital status, level of education, employment, or family income. As their source of information about vaccination, 102 (85%) respondents listed their physician and 66 (55%) listed medical nurses. Internet as the source of information about vaccination was reported by 98 (81.7%) respondents, 75 (62.5%) respondents exchanged information about vaccination with their friends and other parents, and 33 (27.5%) respondents acquired needed information through leaflets, television and magazines. Regarding respondents\u27 satisfaction with the information about vaccination obtained, 77 (64.2%) parents were satisfied and 42 (35%) were dissatisfied with the information they received from their physician and medical nurse. Discussion: Most parents had a positive attitude towards child vaccination and a high percentage of them fulfilled their obligation and regularly vaccinated their children. Less than 1% of parents were explicit opponents of mandatory vaccination. The main reason why parents refused to vaccinate their children was fear from vaccine side effects, and not mistrust of their effectiveness. Inadequate information leads to parents\u27 over-concerns, especially regarding vaccine side effects, which may result in inappropriate decisions regarding vaccination. Conclusion: Although most of our parents had a positive attitude towards child vaccination and a high percentage of them regularly vaccinated their children, additional efforts should be made to educate the public about the importance of vaccination. Healthcare professionals, especially bachelors and masters of nursing, could play greater role in educating parents on the importance of vaccination, its effectiveness and safety, with the aim of raising and maintaining high childhood vaccination rates in Croatia