More and more Romanian parents choose not to vaccinate their children, which has led to a progressive decrease in vaccine coverage for ROR (measles-ore-Russian).
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The organization “Save the Children Romania” collected data in February 2024 for children born in 2018, coverage measured at two doses shows that the national average vaccination for ROR is 69.4%(urban – 68.5% – rural – 70.6%), with high discrepancies between counties, with the highest rate in Giurgiu 97.5%and 44.5% (48.6%), Caraş-Severin and Suceava (both by 53.3%).
In the case of the pneumococcal vaccine, from the data collected in August 2024, for children born in July 2023, coverage measured at three doses, it appears that the national average is 63.1%(urban – 65.6%, rural – 59.8%), with the highest rate in Giurgiu – 95.6%and with the lowest rates (33%), 33%) (36.6%) and Hunedoara (40.1%).
The study focuses on two essential vaccines in the national immunization calendar and an optional vaccine: the ROR (measles-red-rube) vaccine, the conjugated pneumococcal vaccine and the human papilloma virus (HPV).
“The analysis of the data regarding the vaccine coverage during the period 2020-2024 highlights a worrying tendency for the two mandatory vaccines, with significant implications for public health.
The decrease of the vaccination rates has had a significant epidemiological impact, most clearly highlighted by the appearance of the measles epidemic of December 2023. The particularly worrying is the disproportionate impairment of children under one year, three of the deaths caused by the measles being recorded in those between the ages of 7 and 8 months, which were not still eligible for vaccination“, Says” Save the Children. “
Significant differences between rural and urban
According to the study, the different from the urban and rural areas are significant, where the vaccination rates are constantly lower, and the internal legislation in Romania is not sharp in terms of the mandatory or optional character of children vaccination.
“Although this legislative duality creates an ambiguous legal context, the law emphasizes the importance of implementing vaccination as an essential measure for public health ”notes the organization in a press release.
According to “Save the Children”, there are four main reasons why parents refuse to vaccinate their children:
-Attitudinal and behavioral barriers that include post-Covid-19 reluctance, categorical refusal of communities and fear of adverse reactions,
– the socio-cultural barriers represented by cultural, linguistic, religious and high mobility of families.
– At the informational level, the negative impact of the media, misinformation on social networks and myths about vaccination are major obstacles.
– There are also systemic barriers such as excessive bureaucracy, lack of material resources, abolishing vaccination in schools and lack of transport.
Also, following discussions with family doctors, a progressive decrease in vaccine coverage for ROR was found, especially for the second dose administered at 5 years.
“These challenges create a vicious circle in which the lack of booster reduces the efficiency of the immunization program, exposing children to the risk of illness even after the first dose. The pneumococcal vaccine is not a specific challenge in the vaccination process in rural communities. Unlike other vaccines such as ROR or HPV, which frequently generate reluctance and require specific approach strategies, the pneumococcal vaccine is usually given without special problems, often simultaneously with other vaccines”, It is shown in the quoted statement.
“A general reluctance and low interest” in the case of HPV vaccines
Also, family doctors and community nurses say that there is “a general reluctance and low interest” about the anti-HPV vaccine.
“They don’t want to. They don’t want to hear“, just “40 out of 3,000 inhabitants have been vaccinated for HPV“, “It’s about lack of information and fear“
Family doctors also invoke the mentality of parents.
“There are moms who were at gynecology consultations and there they were told to look, it would be good (to be vaccinated) “;” I had requests for HPV vaccination, mostly at the specialist’s indication, for those who already had virus stems. “
Another aspect contained by the organization is the complicated relationship between the family doctor and parents, who can vary according to the case.
“Many doctors report avoidance behaviors from parents, who constantly postpone vaccinations and refuse to take in writing. Doctors see community nurses as ideal intermediaries for communicating with vulnerable or vaccination resistant groups.
Family doctors identify multiple systemic obstacles, such as the absence of non -vaccination consequences and the abolition of school vaccination, which have significantly reduced immunization rates, especially in vulnerable and isolated communities.
From their perspective, cultural and social barriers, as well as high mobility of families, even more complicates vaccination efforts. In addition, in the interaction with parents, doctors notice that the fear of side effects and lack of perception about the severity of preventable diseases through vaccination are significant obstacles in their belief to vaccinate their children“, Mentions the organization” Save the children “.
Doctors request a stricter legislative framework
Doctors seek a stricter legislative framework on vaccination and more intense media campaigns, so to increase vaccination rates.
At the local and operational level, the main needs include: the extension of the community medical assistance network, the reduction of the bureaucracy in reporting the vaccinations, ensuring the transport of patients to the offices and a better involvement of the representatives of the minorities.
“The conclusions of this study emphasizes the importance of health education initiatives, which are extremely necessary to combat the spread of misinformation.
Prioritizing education and facilitating the transmission of correct information to families to help them make informed decisions are essential to build confidence between communities and local health professionals.
At MSD, we are committed to supporting the initiatives that equip the communities with precise information and which promote the right of each child to vaccines that save lives ”said Marcelo Pascual Morales, Managing Director of MSD Romania & Republic of Moldova.
Gabriela Alexandrescu, the executive president of the organization “Save the Children Romania”, emphasizes that “information and awareness programs must be implemented, so that parents make the best decisions for their children”.
“Access to quality medical services also means access to correct information, information and awareness programs, so that parents make the best decisions for their children. At the same time, when we talk about vulnerable socio-economic groups, we must develop programs through which they benefit from handy vaccination ”declares this.
In order to increase the vaccination rates in the rural area in Romania, experts recommend, among other things, the simplification of the vaccination reporting system, the intensive media campaigns at national level, vouchers for transport to the office, or to ensure the transport through the mayors, packages with children’s products, such as diapers, to vaccination, automatic verification of the status, Explanation of adverse reactions, such as fever, but also the benefits of vaccination and presenting the concrete consequences of the diseases that can be prevented.
