Childhood vaccine refusal and hesitancy intentions in Croatia: insights from a population-based study

Abstract

Considering that programmatic data suggest a recent rise in vaccine refusal in Croatia, this study, first of its kind in Southeast Europe, aimed to estimate the prevalence, and sociodemographic, and sociocultural determinants of childhood vaccine refusal and hesitancy (CVRH) intentions among Croatian adults. Multi-stage stratified population-based survey included 1000 individuals aged 18–88 years (M _age = 47.7, SD = 17.8), of whom 51.7% were women. The outcome, a categorical indicator, distinguished among individuals who would approve vaccinating their children (vaccine accepting), those who would approve some but not all vaccines (vaccine hesitant), and those who would refuse vaccination (vaccine refusing). A sizeable minority of participants was characterized by childhood vaccine refusal (10.6%) and hesitancy intentions (19.5%). In a multivariate assessment controlling for parenthood, the odds of vaccine hesitancy were significantly increased by a younger age (AOR = 1.96–3.03, p < .01). Religiosity (AOR = 1.12, p < .05) and the use of alternative medicine (AOR = 2.85, p < .001) increased the odds of vaccine refusal. However, individual characteristics seem to be relatively poor predictors of CVRH intentions in Croatia. Following the social contagion model, future research should move beyond individual-level approach and take into account social interaction and social network effects.

Keywords:

• Vaccine hesitancy
• vaccine refusal
• Croatia
• population-based study
• complementary and alternative medicine

Notes

1. 1 USD = 6.77 HRK.

2. According to the most recent Census data, 86.3% of Croatian population is Roman Catholic, 4.4% is Orthodox Catholic, and 3.8% is non-religious (Croatian Bureau of Statistics, 2011).

3. A vast majority of Croatian citizens are insured through the national social health insurance fund. Mandatory health insurance offers a basic package of health services, with other services being charged at a reduced rate. However, more than 60% of Croatian citizens also buy a voluntary complementary health insurance, which covers all services (Vončina et al., 2012).