Vaccine hesitancy (VH) is an increasing global concern, contributing to vaccine preventable disease outbreaks. According to the Albania Demographic and Health Survey, childhood vaccination rates in Albania have dropped from 94% in 2008-2009 to 75% in 2017-2018. In 2023, WHO reported 83% coverage for the first dose of the MMR vaccine in Albania.The study aimed to (1) assess Albanian parents’ confidence in the safety and effectiveness of vaccines, (2) identify which parental beliefs have the greatest influence on the decisions of hesitant and refusing parents, and (3) determine the prevalence and sources of negative vaccine information and their impact on parental decision-making.This cross-sectional study surveyed 4,082 randomly selected Albanian parents and legal caregivers of children aged 0–18 years. Using a validated and ethically approved anonymous questionnaire, data were collected from participants at randomly selected primary health care centres across Albania. The questionnaire consisted of sociodemographic data and questions about participants’ behaviours, attitudes, and beliefs regarding vaccine safety and efficacy. Data was analysed by using percentages, Pearson’s Chi-squared test, and Fisher’s exact test.27.3 % and 17.6% of all respondents self- reported VH and vaccine refusal, respectively. A large number of hesitant and refusing parents reported that “They are concerned about serious adverse effects of vaccines (73%), “It’s better for children to get fewer vaccines at the same time” (65%), and “It’s better for children to develop immunity by getting sick than by getting vaccinated “(40%). Hesitant and refusing parents are more likely to report having received or heard negative information from their friends and family members (61%), internet (58%) and social media (49 %) P value < 0.001.The majority of hesitant and refusing parents expressed concerns about serious vaccine side effects, prefer fewer vaccines at one time, and believe natural infection is preferable to vaccination, often influenced by negative information from family and friends. These findings highlight the need for targeted strategies to specific parental beliefs.Addressing VH in Albania requires multifaceted, targeted strategies tailored to specific parental beliefs. Engagement of trusted healthcare and community professionals will increase parental confidence and improve childhood vaccine uptake.

Antenatal care is essential for a healthy pregnancy. Moreover, mothers' attitudes towards childhood vaccines are among the most important factors determining infant immunization rates.This study was conducted to assess the pregnant women’s satisfaction with prenatal care and their attitudes toward childhood vaccines.This cross-sectional study included 146 pregnant women who applied to the Çukurova University Training Family Health Centre between 1 May 2024 and 31 July 2024.  Sociodemographic Data Questionnaire, Prenatal Care Satisfaction Scale (PCSS) and Vaccination Attitudes Scale (VAS) were administered.The mean age of pregnant women was 29,4±4,1 year (median: 29). Overall, 98,6% of the participants were married, 68,5% were university graduates, 45,2% were employed, and 50,7% had more than one pregnancy. The mean score of PCSS was 82,9±15,4. The mean total score, and the art of care, technical quality, accessibility, and physical environment subscale scores were significantly lower among participants with two or more pregnancies compared to in their first pregnancy (p=0,014; p=0,041; p=0,032; p=0,004; p=0,009, respectively). The mean VAS score was 17,4±3,8. The efficacy and safety subscale score of pregnant women was significantly associated with employment status (p=0,044), educational level (p=0,004), and income (p=0,003). No significant relationship was found between prenatal care satisfaction and pregnant women’s attitudes toward childhood vaccination.As pregnant women’s educational levels increase, their expectations of health care professionals also rise. Full-time employed and highly educated pregnant women tend to have more positive attitudes towards vaccination.Pregnancy represents an important opportunity for family physicians to influence parental decisions regarding childhood vaccination.

Adult vaccination coverage in France remains low: only about 50% of adults receive the DTP booster at age 65, and fewer than 5% of patients with diabetes have completed pneumococcal vaccination. In August 2023, French regulations expanded vaccination prescription rights to nurses and pharmacists to improve coverage.  The Coeur de Saintonge Health Care Center (CSHCC) is a rural multidisciplinary facility with 42 health-care professionals (general practitioners, nurses, pharmacists, midwives, etc.). In 2024, a vaccination working group of the CSHCC began to develop innovative, collaborative strategies to increase vaccination coverage across its territory, while also improving team cohesion.In May, an interdisciplinary meeting is organised to present annual updates to vaccination guidelines to all CSHCC professionals. Every year, the working group selects a specific vaccination target—based on both national recommendations and local needs—and sets a collective objective to be achieved over a four-month summer period. A visual communication campaign supports both the population and professionals during this period. Monthly updates are provided to health-care professionals regarding individual and collective progress, and final performance feedback is shared at the end of the surveillance period.In the first year, the protocol adopted a competitive structure between professionals, which limited its impact on teambuilding. In response, the second year’s protocol shifted toward a shared goal, creating a more supportive environment and strengthening interprofessional cohesion. This evolution highlighted the importance of collaborative rather than competitive incentives when aiming to engage a broad multidisciplinary team.Over the past two years, adult DTP booster coverage and pneumococcal vaccination among patients with diabetes have significantly improved within the CSHCC population. Notably, these improvements persisted beyond the targeted surveillance periods.The combination of updated guidelines, targeted objectives, structured feedback, and playful teamwork appears to be an effective strategy for increasing vaccination coverage while reinforcing interprofessional collaboration in primary care settings.

Following large-scale national training of over 3,000 primary health-care (PHC) workers on routine immunization practices, a retrospective audit was conducted to evaluate whether these capacity-building efforts translated into measurable improvements in routine vaccination performance. The review took place in the context of newly introduced age-adjusted capitation and results-based financing mechanisms, which increased the importance of accurate immunization registration, timely service delivery, and achievement of national target indicators.A comprehensive audit of immunization coverage among 1445, 0–6-year-old beneficiaries was conducted using multiple data sources, including the national health information system, immunization modules, and locally used planning/monitoring tools. The assessed period covered July 2024 to June 2025. Coverage was reviewed for key vaccines (Hexa-3, MMR-1, MMR-2, Tetra R1, Tetra R2) by age group and PHC team. Strengths included the availability of detailed age-disaggregated data and team-level comparisons. Limitations included inconsistent denominator definitions, unrecorded parental refusals, electronic system constraints, and incomplete accounting for inactive or migrated children.Findings highlighted strong team engagement and functioning reminder systems, but also systemic delays: Hexa-3 timely coverage remained low among 0–11-month-olds (62.9%), MMR-1 coverage at 12–23 months reached only 63.5%, and MMR-2 coverage at 5–6 years remained below the ≥95% target. Delays were often compensated at older ages, suggesting missed opportunities earlier in the schedule. The audit emphasized the need for improved denominator validation, strengthened active follow-up, and routine use of visual analytics to support team-based quality improvement.The findings demonstrate that while overall coverage was acceptable for some vaccines, timeliness and data accuracy remained major challenges. Integrating updated electronic systems and harmonizing local measurement practices with national standards are essential for future improvements.This audit illustrates how systematic, multi-source data review can reveal quality gaps in routine immunization even among well-trained PHC teams and provides actionable insights for improving timely vaccination and meeting national results-based financing targets.

Social media is an important source through which misinformation and disinformation that cause parents to hesitate about vaccines spreads rapidly. Family physicians, thanks to the continuous and trust-based relationship they establish with parents, are in a unique position to reduce this information pollution and provide evidence-based guidance.To evaluate the effect of brief and structured counseling delivered by family physicians on vaccine hesitancy and vaccination decisions among parents who are influenced by social media.This randomized controlled study will be conducted in the family medicine clinics of the training family health centers (EASM) of İzmir Dokuz Eylul University. Parents of children aged 0–5 years who report social media as their main source of vaccine information and who have high vaccine hesitancy (according to the PACV score) will be included in the study. After the baseline assessment (PACV score, sociodemographic data, and the child's vaccination status), participants will be randomly assigned to the intervention or usual-care group. In the intervention group, family physicians will conduct an approximately 10–15-minute structured face-to-face counseling session focusing on common myths, vaccine safety, and the risks of vaccine-preventable diseases, and will provide an evidence-based information leaflet. The control group will receive routine counseling. PACV scores and on-time vaccination status will be reassessed 1–3 months later.The study is in the planning phase. In the intervention group, compared with usual care, a greater decrease in PACV scores and a higher rate of on-time vaccination are targeted.The study is in the planning phase. In the intervention group, compared with usual care, a greater decrease in PACV scores and a higher rate of on-time vaccination are targeted.If found effective, this individualized, brief, and structured counseling, tailored to parents influenced by social media, may be recommended to be integrated into routine family medicine practice as a practical communication strategy against vaccine hesitancy.

Childhood immunization coverage has declined globally since the COVID-19 pandemic, raising concerns about the capacity of Primary Health Care (PHC) to sustain routine preventive services. In Brazil, PHC teams coordinate the childhood vaccination pathway, including neonatal follow-up, routine infant care and outreach activities. However, regional disparities and post-pandemic behavioral changes may affect the ability of PHC to maintain vaccination coverage.To assess regional trends in childhood vaccination coverage in Brazil from 2016 to 2022, comparing pre-pandemic and post-pandemic periods and identifying vaccines most affected within the PHC child care continuum.This ecological time-series study used secondary data from the National Immunization Program. Five childhood vaccines representing key stages of PHC-based child care were analyzed: BCG, Hepatitis B (30 days), Pentavalent, Poliomyelitis (1 year) and Yellow Fever. Annual coverage (%) was compiled for the five Brazilian macro-regions from 2016 to 2022. Temporal trends were estimated using Prais–Winsten regression, generating Annual Percent Change (APC) and p-values. The time frame was structured to evaluate changes between the pre-pandemic period (2016–2019) and the post-pandemic period (2020–2022).BCG coverage showed a borderline decline in the Southeast and a significant decline in the Centre-West. Pentavalent vaccination declined significantly in the North, Southeast and Centre-West. Poliomyelitis coverage decreased significantly in the Southeast and Centre-West. Yellow fever vaccination declined significantly in endemic regions, while increasing borderline in the Northeast. Hepatitis B (30 days) remained stable across all regions.The findings indicate progressive erosion of childhood immunization within PHC, especially for vaccines that depend on continuous engagement with PHC teams. Beyond operational disruptions, the post-pandemic period has been marked by growing vaccine hesitancy, misinformation and the circulation of antivaccine narratives, which have disproportionately affected parental confidence in routine childhood immunization. These behavioral factors may have amplified pre-existing regional inequalities and hindered the effectiveness of PHC-based strategies such as active outreach, counseling and community engagement.Childhood vaccination coverage in Brazil declined unevenly, with significant reductions in key PHC-dependent vaccines. Strengthening PHC capacity, rebuilding vaccine confidence and implementing evidence-based communication strategies are essential to reverse post-pandemic declines and address emerging vaccine hesitancy.