Impact of sociodemographic factors on children’s immunization in Bulgaria.

Introduction: Vaccinations have been touted as one of the ‘‘greatest public health achievements’’, but the rate of under-vaccination in child population is steadily declining, especially in low-income groups. Many studies show, that country-specific parental socio-demographic factors may influence on children’s immunization coverage. Aim: To assess which family socio-demographic factors influence parental vaccine hesitancy. Methods: A survey was conducted among 1195 parents of children under the age of 7y., between 2015-2017, mean age of 30.96.4y., of Bulgarian or other ethnic groups, living in Eastern Bulgaria. Questions about family socio-demographic factors, attitude, beliefs and fears were included. Results: The share of parents who state that they would not have vaccinated their children if the vaccination program was not compulsory is 20.9%. They are mainly in the age range 30- 39(42,4%;Spearman’s = 0,13;o<0,0001), with higher education(57.6%; Pearson’s r=- 0,13;o<0,001), of Bulgarian ethnicity (73,7%;Pearson’s r=-0,12;o<0,0001%), living in a larger town, mainly gathering information about vaccines from the Internet(29.9%), mass media(30%) and/or relatives and friends(25.5%). Even of compulsory vaccination programs, these parents tend to have children with missed or postponed vaccinations. Insufficient knowledge and/or shortcomings of the health system are the leading factors for parents with lower education and Roma ethnic group living in relatively smaller settlements, who do not to have a full-scale vaccination program of their children. Conclusions: Socio-demographic differences in parental attitudes towards compulsory vaccination require a differentiated approach. Preventive health care work is needed to overcome the growing anti-vaccine attitudes. Education and proper evidence-based proofs about vaccines and their benefits is needed for one types of a population group while increased knowledge and improved access to medical services for another population group. Key messages: A large-scale study, characterized as a representative to the country, about the parents’ attitudes towards immunization as a whole in the Republic of Bulgaria was carried out. Some socio-demographic factors that might have affected the readiness of parents to vaccinate their children have been analyzed. [ABSTRACT FROM AUTHOR]