Parental childhood vaccine hesitancy and the National Vaccination Programme, in Portugal

Abstract Background Despite the invaluable contribution of vaccination to Public Health, vaccine hesitancy is increasing in the European Union. Several factors are associated with parental childhood vaccine hesitancy (PCVH). In Portugal, there are no known studies specifically addressing vaccine delay in infants. Objectives We aimed to estimate the proportion of parental childhood vaccine hesitancy (PCVH) up to 12 months of age in Portugal, and to determine vaccination (confidence and information) and National Vaccination Programme (NVP) associated factors. Methods We performed a cross-sectional study on a convenience sample, using an anonymous online questionnaire directed to parents of children up to 17 months old, living in Portugal. We performed an exploratory factor analysis, followed by logistic regression. We obtained crude (OR) and parental vaccination status’ adjusted odds ratios (aOR). Results PCVH proportion was estimated at 1.8% (95%CI: 1.0%-3.0%; n = 790). The exploratory factor analysis resulted in five dimensions: 1. vaccine confidence; 2. access to enough/reliable information about vaccines; 3. access to NVP; 4. vaccination schedule; 5. trust in healthcare professionals’ information about vaccines. Vaccine confidence (aOR=0.29, 95%CI: 0.14-0.54), vaccination schedule (aOR=0.31, 95%CI: 0.15-0.58) and trust in information about vaccines provided by health professionals (aOR=0.30, 95%CI: 0.16-0.53) were protective dimensions of PCVH. Conclusions The low proportion of PCVH observed is consistent with the high immunisation coverage in Portugal. Vaccination schedule, trust in vaccines, and in the information provided by healthcare professionals are factors associated with lower vaccine hesitancy. This highlights the importance of trust and healthcare professionals in maintaining high vaccination coverage in Portugal. Key messages • Parental childhood vaccine hesitancy (PCVH) proportion was 1.8%. Vaccine confidence, vaccination schedule and trust in information provided by health professionals were protective factors of PCVH. • Trust in vaccines and in healthcare professionals seem to play a key role in keeping a high immunisation coverage in Portugal.