Decision making processes underlying avoidance of mandatory child vaccination in Croatia – a qualitative study

Abstract

Despite extensive research evidencing child vaccination is safe and effective, we are witnessing a trend of increasing vaccine hesitancy which is listed among the top ten global health threats. Although some countries incorporate mandatory vaccination programs, no particularly efficient strategies for addressing vaccine avoidance have so far been identified. Within this study we investigated perceptions and reasoning of vaccine hesitant parents from Croatia where child vaccination is mandatory. The aims were to reveal different strategies by which they avoid mandatory vaccination schedules and hypothetical situations in which they would reconsider vaccinating, as well as to identify features of related decision-making. We conducted 25 semi-structured interviews with vaccine hesitant parents and analyzed the data using the framework of thematic analyses. The identified themes were related to the parents' decision-making process, reflection as well as justification of their decision, avoidance behavior of mandatory vaccination schedules and related consequences, dealing with outcomes of the decision and reconsidering vaccinating. The results support and extend previous findings regarding vaccine reasoning, linking hesitancy with the experientially intuitive thinking style and social intuitionist model of moral reasoning. The findings provide important insights into vaccination avoidance and potential for reconsideration, as well as dealing with related risks. Furthermore, we offer a general framework as well as practical guidelines that may help the development of strategies aimed at increasing vaccination rates.

Vaccine hesitancy and cognitive biases: Evidence for tailored communication with parents

“…In a study conducted in London [43] it emerged that parents distrusted the Government and believed that it could be leveraged by pharmaceutical companies or other economic interests. In another study in Croatia investigating the cognitive processes underlying vaccine-hesitant parents’ decision-making, the vaccine conspiracy belief was found to be associated with VH [44] .…”

Vaccine hesitancy among Croatian biology students with special emphasis on COVID-19 vaccine

“…Vaccine hesitancy has been previously recognized as a problem in Croatia. Hesitancy has been recorded among health care providers (28,29) and also towards mandatory child vaccination programs (30)(31)(32). According to available data, level of COVID-19 vaccine acceptance in Croatia in November 2020 was very low (41%) (14).…”