Are pediatricians responsible for maintaining high MMR vaccination coverage? Nationwide survey on parental knowledge and attitudes towards MMR vaccine in Serbia

AIM: To assess parental knowledge and attitudes related to MMR vaccination and to determine factors associated with parental decision whether to vaccinate their child with MMR vaccine in Serbian population. METHODS: The selection of participants was performed using multi-phase sampling. Seventeen out of the total 160 public health centers on the territory of Republic of Serbia were randomly selected. All parents of children up to the age of 7 who visited the pediatrician at the public health centers from June to August 2017 were recruited. Parents filled in an anonymous questionnaire regarding their knowledge, attitudes and practices in immunization with MMR vaccine. The relative contribution of different factors was explored by univariable and multivariable logistic regression analysis. RESULTS: The majority of parents were female (75.2%), with mean age of 34.3 ± 5.7 years, and the average age of children was 4.7 ± 2.4 years, 53.7% of them were girls. In the multivariable model, getting information on vaccination from a pediatrician was associated with 7.5 fold increased probability to vaccinate child with MMR vaccine (OR = 7.52; 95% CI 2.73–20.74; p<0.001), while previous vaccination of the child increased this chance two times (OR = 2.07; 95% CI 1.01–4.27; p = 0.048), and having two children was associated with 84% increase in chance of vaccinating child with MMR vaccine compared to having one child or three or more children (OR = 1.84; 95% CI 1.03–3.29; p = 0.040). CONCLUSION: Our study emphasized the key role of pediatricians in the formation of parental attitude on MMR vaccination of their child.