title: Factors Associated with Parental Refusal of Routine Vaccination in the Czech Republic.
abstract: OBJECTIVE
  Routine vaccination is one of the most important preventive methods which is responsible for the decreasing trend of morbidity and mortality of vaccine preventable infectious diseases, their complications and sequelae. The impact of vaccination on declining trend of these diseases is well known and confirmed by a large number of epidemiological studies. In the Czech Republic, there is high vaccination coverage in regards to most vaccine preventable diseases. However, during the last decade proportion of parents refusing routine vaccination of their children due to different factors is increasing. The presented study evaluates current situation in the Czech Republic and describes the most significant factors in parents decision making.
  
  
  METHODS
  The study was conducted between 1 July 2013 and 31 March 2014 as a questionnaire based survey (cross-sectional study). The questionnaire was created with multiple choice answers. Questions were addressed to parents or legal representatives of children aged 0-18 years. Types of questions were divided into several subgroups. The study was performed in the Czech Republic in two different districts of Prague and Zlín.
  
  
  RESULTS
  In the sample size (n=480) we detected 11 parents who refused vaccination of 11 children (2.29%). The most often refused vaccines in the prevalence study were hexavaccine (1st dose) and measles, mumps and rubella vaccine (1st dose). The hexavaccine includes tetanic anatoxin, diphtheric anatoxin, acellular pertussis vaccine, conjugate vaccine against Haemophilus influenzae b, inactivated polio vaccine, and recombinant vaccine against viral hepatitis B. The measles, mumps, rubella vaccine contains live attenuated viruses of measles, mumps, rubella.
  
  
  CONCLUSIONS
  We observed increasing trend of routine vaccination refusal in children during the last ten years (compared to situation in the year 2004, p<0.001). The most important factors associated with this progression were distrust to vaccination, fear of some vaccine components and fear of adverse reactions.
authors: Third Faculty of Medicine, Charles University, Prague, Czech Republic.
authors: Jana
authors: J
authors: Dáňová
authors: Third Faculty of Medicine, Charles University, Prague, Czech Republic.
authors: Jiří
authors: J
authors: Šálek
authors: Third Faculty of Medicine, Charles University, Prague, Czech Republic.
authors: Aneta
authors: A
authors: Kocourková
authors: Third Faculty of Medicine, Charles University, Prague, Czech Republic.
authors: Alexander M
authors: AM
authors: Čelko
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D018153:Czech Republic; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010290:Parents / Q000523:psychology*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016312:Treatment Refusal / Q000523:psychology*; D014611:Vaccination / Q000523:psychology*
keywords: children; parents; refusal of vaccination; routine vaccination; vaccine preventable disease