Barriers and enablers to increasing seasonal influenza vaccination in children in Portugal

Background

Portugal has recently expanded seasonal influenza vaccination to young children, reinforcing its preventive public health strategy1,2. Although childhood vaccination coverage is historically high, influenza uptake has followed a different trajectory, representing a distinct implementation challenge. This could be influenced by parental perceptions, professional attitudes, service delivery processes3, and the growing impact of misinformation and disinformation4. A nuanced understanding of these determinants is essential to sustain trust and ensure equitable pediatric coverage4.

Methods

PEDIVAC is a mixed-methods project. Guided by a literature review and stakeholder engagement, it explores perceptions, experiences, and priorities related to pediatric influenza vaccination in Portugal. Qualitative methods involve parents and caregivers, healthcare professionals, and key stakeholders within the vaccination ecosystem, including organizations involved in childhood immunization. PEDIVAC also comprises a cost-effectiveness model adapted to the Portuguese context, thus ensuring local representation. Data are analyzed thematically to identify barriers, facilitators, and acceptable implementation strategies, including innovative approaches such as school-based vaccination.

Results

Preliminary findings suggest that uptake is shaped by informational, relational, and organizational factors. Parents and caregivers value clear guidance and consistent communication from trusted sources, while some healthcare professionals report uncertainty regarding vaccine necessity, effectiveness, and integration into routine care. Stakeholders also emphasize practical delivery models and coordinated communication strategies.

Conclusions

By centering the perspectives of parents, educators, and healthcare professionals, PEDIVAC aims to provide actionable insights to support more effective and acceptable strategies to increase childhood influenza vaccination in Portugal.

Key messages

• Understanding the perspectives of parents, educators and health professionals is central to improving childhood influenza vaccination.

• Addressing disinformation, misinformation, and trust barriers on child influenza vaccination, both from citizens and healthcare professionals, can strengthen vaccine confidence and uptake, rising VCR.