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Factors driving the attitudes and hesitancy of Albanian parents toward Covid-19 vaccination of children.
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1  Catholic University ' Our Lady of Good Counsel'
Academic Editor: François Meurens

Published: 01 December 2023 by MDPI in The 1st International Electronic Conference on Vaccines session Vaccines and Society


The “3Cs” model of hesitancy claims that vaccine hesitancy is influenced by three factors such as complacency, convenience, and confidence which drive the acceptance or refusal of vaccines. Vaccine hesitancy is context-, time-, place- and vaccine-specific. This study aims to analyze different factors influencing perceptions and attitudes of Albanian parents toward covid-19 vaccination of children. The Anti-Covid-19 vaccine remains unapproved for children younger than 12 in Albania.


A validated questionnaire composed of 33 elements was used for the purpose of this study. The study was conducted on a sample of parents/caregivers of children aged 0 months to 18 years. There first section of the questionnaire is composed of demographic questions. The other sections aimed to collect data about economic level, political status of the country where they live, policies toward vaccination, parent’s perceptions and beliefs about covid-19 vaccines in children and access to immunization settings. The survey tool was composed of questions aimed to measure the complacency, convenience and confidence of the respondents toward Covid-2.

The data collected from the questionnaire were first coded and then studied using statistical software STATA13 and SPSS21. The data analysis was done based on 3 domains.

  1. The association of socio-demographic characteristics of parents with their perceptions regarding the safety of children's vaccines in general.
  2. The association of the experience of parents with COVID-19 disease with their perception of the safety of the Anti-Covid-19 vaccine
  3. The association of parental perceptions on COVID -19 infection with their perceptions of the safety of the Anti-Covid-19 vaccine in children

For each of these sub-divisions (sections), descriptive statistics (frequencies and percentages) and assessment of the association of different variables (socio-demographic; experience with COVID; parental perceptions on COVID) with the basic variable which is "perception of safety of the ANTI COVID 19 vaccine in children" through Pearson's chi-square test was conducted.

Then, using the multinomial regression method, the factors that influence the concrete administration of vaccination among children were analyzed. For this purpose, the following are considered as independent variables: age; the country where Albanians live; schooling; vaccination obligation in the respective state; the child's experience with COVID-19; the perceived safety of the COVID-19 vaccine (categorized in: do not agree at all; partially agree; completely agree).

Data were analyzed using the SPSS statistic program and R-project.


A total of 600 parents/caregivers responded to the questionnaire. The parents/caregivers that responded to the questionnaire were categorized in 3 groups: Albanian parents living in Albania, Albanian parents living in diaspore, Albanian parents living in Kosovo. The three groups were confronted between them in terms of perceptions and attitudes toward vaccination of children aged 0-18 years old with the SARS Cov-19 vaccine.

94.5% of the respondents were represented by mother. 52% of the respondents had a University degree and 33.1% of them had a post-graduate degree such as Doctoral studies, Master or Specialization diploma. 58% of the respondents declared to have a middle income. The age of the children in 39% of the cases was 0-2 years old, 16% of the respondents were parents of children aged 12-18 years old. 76% of the respondents declared that they would not vaccinate their child with the Covid-19 vaccine. 50% of them did not consider important the administration of covid-19 vaccine to their children.

From the regression analysis the following results were obtained

  • Parents living in Kosovo and Diaspora were more sceptic about the safety of Anti-Covid vaccines compared to parents living in Albania.
  • Parents of children aged 0-5 years old were more sceptic about the safety of Anti-Covid vaccines compared to parents of children aged more than 5 years old.
  • The possibility of getting the children vaccinated vs not getting the vaccination increases by 2.3 times if the vaccination is mandatory
  • The hesitancy of administering the vaccination to children compared to the total refusal increase es by 3 times if the vaccination is perceived as safe


From the results of this study several factors seem to influence the perceptions of parents toward Covid-19 vaccination of their children. The negative perceptions toward vaccination of their child were linked to mild form of the disease passed by their children and fear of adverse events. While access to immunization settings and economic level seemed to not influence the attitudes of parents toward vaccination. The perceived safety of the Anti-Covid-19 vaccine had a real impact on the implementation of vaccination in children: the positive perception of the safety of the Anti-Covid-19 vaccine was related to decreased refusal to administer the vaccination to children.

The negative perceptions of parents toward covid-19 vaccine seems to influence their attitude toward other childhood vaccinations, delaying the immunization time of their child which could by itself result in an increase of incidence of vaccine preventable diseases.

Keywords: vaccines; vaccine hesitancy; Covid-19; Anti Covid vaccines