Experience with Parental Vaccination Refusal and Attitudes about Vaccinations of Pediatricians in Greece

Aim: To study the experience of Greek pediatricians with parents who refuse their children's vaccination and their attitudes towards vaccinations.
Study Design: Nation-wide questionnaire-based survey conducted from February through May 2013.
Methodology: We included 211 pediatricians.
Results: A total of 190 (90%) pediatricians reported that they had encountered at least one case of parental vaccination refusal in the past. During 2012, the pediatricians faced a mean of 10.5 cases of vaccination refusals / 1000 vaccinations. The human papilloma virus (HPV) vaccine was the most frequently refused vaccine, followed by the measles-mumps-rubella (MMR) vaccine. "Fear of adverse effects" was the most frequent reason of vaccination refusal (83.8%) followed by "Use of alternative medicine" (46.4%) and "Anti-vaccination belief against all vaccines" (45.3%). Internet was the most frequent source of information for parents who refused vaccination. Of 201 pediatricians, 135 (67.2%) stated that "Childhood vaccinations should be mandatory for primary-school entry", while 28 (13.9%) stated that "Parents have the right to refuse their children's vaccinations". Lastly, 130 (61.6%) pediatricians stated that they had concerns about vaccines, mainly about their costs (46.2%).
Conclusion: Refusal of vaccinations by parents is not frequent in Greece and concerns mainly the HPV and the MMR vaccines. Pediatricians should improve their ability to deal with this issue.