Factors influencing decisions of parents of preschool children regarding childhood vaccination

Background

In recent years, Lithuania, similarly to many other countries, has experienced declining childhood vaccination coverage and the re-emergence of vaccine-preventable diseases. Between 2012 and 2022, measles, mumps, and rubella vaccination coverage decreased by 7.5%, reaching 86.1%. Vaccine refusal remains a significant public health concern, as reduced vaccination uptake increases disease incidence and the risk of severe complications.

Aim

To evaluate the factors influencing parental decisions regarding vaccination of preschool-aged children.

Methods

An anonymous questionnaire-based survey was conducted in 2024 in two preschool institutions in Marijampolė. A total of 163 parents participated in the study (response rate 67.1%). Associations between categorical variables were assessed using the chi-square and Z tests, with statistical significance set at p<0.05.

Results

90.2% of participating parents reported that their child had been vaccinated according to the national immunization schedule. The main reasons for vaccine refusal included concerns about vaccine safety, potential adverse effects, and doubts regarding vaccine effectiveness in preventing disease. More than half of respondents had not chosen additional vaccines outside the national schedule, whereas 33.7% reported vaccinating their child against tick-borne encephalitis. Prior to making vaccination decisions, parents considered the opinion of a family physician or pediatrician, personal beliefs, and information presented in scientific literature to be important. Factors significantly associated with vaccination decisions included the preschool institution attended, parental age, education level, marital status, child’s age, and average monthly family income (p<0.05).

Conclusions

Parental decisions regarding childhood vaccination are primarily influenced by healthcare professionals’ recommendations, personal beliefs, and scientific information sources.

Key messages

• Most preschool children are vaccinated per schedule, but hesitancy remains due to concerns about safety, side effects, and effectiveness.

• Parents’ vaccination decisions are strongly influenced by healthcare professionals and socio-demographic factors, highlighting the need for targeted communication.