Link between COVID-19 Vaccination Attitudes and Support for Mandatory Childhood Vaccinations

INTRODUCTION: Despite vaccines being a proven intervention over time to limit the spread of infectious diseases, in recent decades there has been fluctuation among parents regarding the mandatory immunization calendar in Bulgaria. AIM: This study aimed to investigate the impact of the COVID-19 pandemic on parents’ decisions regarding mandatory immunizations for children in Bulgaria. METHODS: A total of 1200 Bulgarian citizens participated in the cross-sectional study, which included questions related to socio-demographic indicators, COVID vaccination status, attitudes towards mandatory immunization, beliefs in personal doctors, rumors about vaccines, and the desire to vaccinate their own children against COVID-19. Data was analyzed using Jamovi software, and a chi-square test for association was used to investigate the relationship between COVID-19 vaccination status and attitudes towards mandatory childhood vaccinations. RESULTS: The study found that 93% of the 1133 participants who expressed an opinion on mandatory childhood vaccinations had a positive attitude. Respondents who were vaccinated against COVID-19 and had a positive attitude towards mandatory COVID vaccination were more likely to support mandatory childhood vaccinations – 98.8% vs 1.2% (χ(2)=27.6; p < 0.001). Those who perceived moderate to high benefits of COVID vaccines were also more likely to support mandatory childhood vaccinations (χ(2)=43.4; p < 0.001). Participants who had not heard of or did not believe in rumors about COVID vaccines and those who had trust in primary care physicians were more likely to support mandatory childhood vaccinations. CONCLUSIONS: The study indicates that attitudes towards COVID vaccination could influence parents’ decisions on mandatory vaccines for children in Bulgaria. If parents distrust the safety and effectiveness of COVID vaccines, they may also be hesitant towards mandatory vaccinations for children. KEY MESSAGES: • Implementation of a proper vaccination policy is necessary to protect public health and limit infectious diseases. • The COVID-19 pandemic has raised questions about the possibility of including mandatory vaccination against COVID-19 in Bulgaria's immunization calendar.