This is an early access version
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Primary Health Center Gračanica , Gračanica , Bosnia and Herzegovina
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Department of anatomy, Medical faculty, University of Tuzla , Tuzla , Bosnia and Herzegovina
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Internal medicine , University Clinical Center Tuzla , Tuzla , Bosnia and Herzegovina
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University Clinical Center Tuzla , Tuzla , Bosnia and Herzegovina
University Clinical Center Tuzla , Tuzla , Bosnia and Herzegovina
Aim Vaccine hesitancy challenges global public health, with parental attitudes significantly impacting childhood immunization. This study examined parental perceptions of vaccine safety, effectiveness, and decision-making factors in Bosnia and Herzegovina.
Methods A cross-sectional survey was conducted in March 2025 with 233 parents at a Primary Healthcare Center in Gračanica. A structured questionnaire based on the Parent Attitude about Childhood Vaccines (PACV) assessed sociodemographic data, vaccination experiences, information sources, and attitudes toward vaccines using a Likert scale.
Results Among 233 participants, 195 (83.7%) fully vaccinated their children, 30 (12.9%) practiced selective vaccination, and eight (3.4%) refused all vaccines. Vaccine hesitancy was significantly associated with lower education, (26.3% vs. 5.1%; p<0.001), rural residence (76.3% vs. 48.2%; p=0.002), and having three or more children (34.2% vs. 12.3%; p=0.01). Trust in healthcare professionals strongly influenced behavior, with 178 (91.3%) of parents who fully trusted doctors adhering to the immunization schedule. Concerns about autism were reported by 14 (36.8%) of hesitant parents and were significantly associated with delayed or refused vaccination (p<0.001).
Conclusion Although overall confidence was high, vaccine hesitancy persisted due to perceived risks. Strengthening healthcare communication and addressing misinformation, particularly autism concerns, may help improve vaccine uptake.
Keywords: health knowledge, immunization program, public health, vaccination coverage
Conceptualization, A.T., E.M., M.B. and A.Ć.; Data curation, A.T.; Investigation, A.T. and E.B.; Methodology, A.T. and E.M.; Supervision, A.T., E.M., E.B., M.B. and A.Ć.; Writing – review & editing, A.T. and E.M.; Writing – original draft, E.M. and M.B.; Formal Analysis, E.B., M.B. and A.Ć.; Software, E.B. All authors have read and agreed to the published version of the manuscript.
No specific funding was received for this study
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