Greek Parents’ Confidence in Childhood Vaccination: Immunisation Culture Maintained across Family Generations

Background: In addition to the upper-class Europeans, anti-vaccination ideas are now spreading among middle-class parents of young children in many European countries. In Greece, there are high levels of child vaccine confidence and high coverage appears to be sustained for most of the recommended vaccines; however, delay of scheduled shots compromising age-appropriate protection has been recently observed.

Objective: We conducted a cross-sectional study to investigate confidence -and identify its determinants- in recommended childhood vaccinations among middle-class parents in Greece.

Methods: We developed and validated a questionnaire on parental confidence in childhood vaccination (Q-PCCV). In March-May 2019, parents of children aged 0-12 years were invited to complete the paper-based Q-PPCCV. Respondents reported their level of agreement on a five-point Likert scale. A logistic regression was performed to examine associations between parents’ confidence ratings and their characteristics, information-seeking behaviour and childhood vaccination intention.

Results: Overall, 502 parents [mothers: 361 (72%); median age: 42 years] fully completed the Q-PCCV. The 470/502 (93.6%) agreed on the importance of childhood vaccination. The Q-PCCV showed good validity and reliability (alpha=0.81). Two construct dimensions (parental relying on the national child vaccination schedule and espousing the virtues of vaccination) were revealed explaining 62.2% of variance. Parents’ confidence in childhood vaccination was positively associated with their having a higher level of education [beta=9.12(1.76,16.5); t=2.44; p=0.015], being better at remembering their own vaccination history [beta=24.6(4.99,44.2); t=2.4; p=0.014], being mostly informed by the Health authorities [beta=19.8(4.07,35.5); t=2.48; p=0.014] and being less hesitant to vaccinate their own child [beta=-35(-54.8,-15.3); t=-3.48; p=0.001].

Conclusions: Our Greek middle-class parents remain highly confident in childhood vaccination. They are convinced of child vaccinations benefits complying with the national child vaccination schedule. Having a higher education, they preferably seek guidance from the Health authorities; and unhesitatingly vaccinate their offspring, thus perpetuating the culture of immunisation across family generations.