Sociodemographic factors influencing childhood vaccination in Albania: a cross-sectional study

Vaccine hesitancy (VH) is a growing threat to global health. In Albania, VH has increased over the past decade, with childhood immunization rates declining from 94% in 2008-2009 to 75% in 2017-2018. Current literature exploring sociodemographic influences on VH in Albania is limited. This study aims to identify key sociodemographic factors associated with VH among caregivers of children aged 0-18 years. A total of 4082 Albanian parents or legal caregivers participated in this cross-sectional study. A validated, anonymous questionnaire was used to collect sociodemographic data, behaviours and attitudes towards vaccines, and beliefs regarding vaccines safety and efficacy. Caregivers were randomly selected from health centres across Albania. VH and vaccine refusal were self-reported by 27.3% and 17.6% of respondents, respectively. Regression analysis identified significant factors influencingVH: marital status (single, widowed, separated, or divorced) (OR 1.91, 95% CI 1.4-2.7), urban residency (OR 1.7, 95% CI 1.4-2.0), having more than four children (OR 10.02, 95% CI 5.2-19.3), doctorate level education (OR 1.99, 95% CI 1.2-3.4), very poor income (OR 13.82, 95% CI 7.0-27.5), Roma ethnicity (OR 18.03, 95% CI 8.2-39.6), Evangelical Christian affiliation (OR 3.33, 95% CI 2.3-4.8), and Muslim faith (OR 1.33, 95% CI 1.1-1.7). Consulting a paediatrician or healthcare professional increased the odds of VH/refusal by 1.88 and 2.09 times, respectively. Sociodemographic factors are significant factors influencing parental VH in Albania. These insights can lead public health decision-makers in targeting hesitant parent groups and developing educational interventions that address specific barriers and concerns.