Knowledge and attitudes towards vaccination in the Croatian adolescent population

BACKGROUND: Adolescents are a large and vulnerable group for infectious and other diseases. A good insight into their specific needs and their understanding of disease and prevention is necessary to adapt vaccination strategies for this population subgroup characterized by constant change and evolution. This study aimed to explore knowledge and attitudes about vaccination among the Croatian adolescent population. METHODS: This online cross-sectional questionnaire study was conducted from January 2021 to April 2021 in a convenient sample of adolescents from the northwestern part of Croatia. The knowledge was assessed through a specially designed validated questionnaire. The Vaccination Attitudes Examination Scale (VAX) was used to assess attitudes towards vaccination in the study population, where the higher scores on the VAX scale reflect more negative attitudes toward vaccination. RESULTS: The study included 1012 adolescents (29.2% males and 70.8% females). The median age of all subjects was 17.0 (interquartile range 17.0 - 18.0) years. According to the knowledge, there were 29.5% of students with poor, 53.9% of students with average and 16.6% of students with good knowledge about vaccination. The median VAX scale score was 50.0 (interquartile range 43.0-59.0). Male adolescents more frequently had poor knowledge about vaccination (P = 0.028), while female adolescents had more negative attitudes towards vaccination (P = 0.001). The study revealed that there was a positive correlation between poor knowledge and more negative attitudes towards vaccination in the studied population (P < 0.001; rs = 0.260). CONCLUSIONS: The study showed that a large proportion of Croatian adolescents have poor knowledge about vaccination and negative attitudes toward vaccination. Public health programs specially designed for this vulnerable population subgroup are needed to successfully tackle observed negative indicators. KEY MESSAGES: • Public health interventions directed towards the suppression of negative attitudes about vaccination must involve younger population subgroups, such as adolescents. • Positive attitudes as well as better knowledge about vaccination among adolescents are crucial preconditions for adequate vaccination coverage.