THE VACCINATION IN ALBANIA; AN ASSESSMENT OF THE LEVEL OF KNOWLEDGE AND BEHAVIOUR OF THE POPULATION REGARDING VACCINES

Abstract

A vaccine is a biological product that improves immunity against a particular disease. The vaccine contains an agent similar to the disease-causing microorganism, usually a weakened or killed form of the microbe, its toxin, or one of its membrane proteins. The agent stimulates the immune system to recognize the foreign agent, destroy it and "remember" it in case it comes into contact with it again. Active immunization is one of the most effective preventive methods and has brought drastic results in world health. About 3 million deaths are avoided each year, the disease of poliomyelitis is very close to being eradicated, measles, has been brought under control. Immunization remains one of the most important and cost-effective discoveries in health, even more impactful than antibiotics (this is also true for the more expensive new vaccines). The direct impact is in reducing hospitalization costs, further treatments and disability costs. By maintaining children's health, immunization leads to increased life expectancy and increase active time at work and thus contributes to reducing poverty. The total costs of this process have decreased exponentially and it is expected to follow the same trend due to: Increasing the number of producers, reducing the price of vaccines, improving the efficiency of the vaccination process, reducing the number of medical staff needed. In Albania, the national immunization program is regulated and defined by law 15/2016. The law defines the population groups in which vaccination is mandatory. For every child who enters a nursery, kindergarten, school or higher education institution for the first time, it is mandatory to provide him, from the health institutions, with a document certifying the vaccination carried out according to the relevant calendar. One of their most important tasks is the drafting of the National Immunization Calendar, for all age groups, against vaccine-preventable diseases that is approved by the Ministery of Health. Children from 0-18 years old, people who are at risk and pose a risk to others, to prevent the spread of infectious diseases, health personnel and personnel who care for children, elderly persons, persons with disabilities; students of medical sciences, those enrolled in long-term specializations in medical specialties The purpose of this study is to evaluate the level of knowledge, behavior and practice of the population regarding vaccines. The achievement of this goal was realized through the definition of specific objectives: Estimating coverage rates with mandatory vaccines • Assessment of the dependence of the vaccination coverage rate on selected factors: • Social characteristics (education) • Assessment of the level of knowledge on the importance of vaccination as a form of disease prevention. • Assessment of perception on adverse effects of vaccines. • Assessment of the relationship between the level of knowledge about vaccines and demographic and social factors. Evaluation of the effectiveness of mandatory and voluntary vaccination The study was conducted using an online questionnaire. Questions were designed to collect information on knowledge and use of vaccines in Albania. In total, 186 randomly selected individuals participated in this questionnaire; 62%female, 38%male; 34% in group-age 25-35 years old, 16%in 35-45 years old, ect. 90% answer that they belive that vaccines are important in preventing disease, and only 2% don’t believe in vaccines, the others answer were don’t know. There is a significant percentage of 18% individuals who doubt the safety of vaccines. It is clearly seen that education has a very large impact on knowledge about vaccines. 91% of the sample were vaccinated with the mandatory vaccines. This data also corresponds to the official statistics of the coverage rate of the population with mandatory vaccinations. 4% of the vaccinated were affected by the disease against which they were vaccinated. As predicted, gender has no effect on vaccine knowledge. Our results are similar with another study which was performed in 2021 in Albania and find that: among mothers of under-5- year-old children in Albania, 78.1% (95% CI: 74.3, 81.5) never postponed or rejected childhood vaccines. Immunisation delay was reported by 21.3% (18.0, 25.1) of mothers, but a majority (67.0%) were caused by the infant’s sickness at the time of vaccination, while a minority (6.1%) due to mothers’ concerns about vaccine safety and side effects. Vaccine confidence was high among the mothers at 92.9% (91.0, 94.4) Vaccination is clearly one of the most effective public health interventions. One of the key factors influencing the success of vaccination is a high coverage rate, which is directly influenced by the acceptance of vaccines by the population. Ongoing education and informing the population about the benefits of vaccination and their safety is of particular importance.

Keywords

• vaccination
• Albania
• immunization

References

1. [1] Lombard M, Pastoret PP, Moulin AM. A brief history of vaccines and vaccination. Rev Sci Tech Int Epiz. 2007;26(1):29-48.
2. [2] Blevins SM, Bronze MS. Robert Koch and the 'golden age' of bacteriology. Int J Infect Dis. 2010;14(9):e744-751. [CrossRef]
3. [3] Bonhoeffer J, Zumbrunn B, Heininger U. Reporting of vaccine safety data in publications: Systematic review. Pharmacoepidemiol Drug Saf. 2005;14(2):101-106.
4. [4] Rothman KJ, Greenland S. Causation and causal inference (Chapter 2), p. 7-28. In: Modern Epidemiology (2nd edition), Editors: Rothman KJ, Greenland S. Philadelphia: Lippincott-Raven; 1998.
5. [5] Shimabukuro TT, Nguyen M, Martin D, DeStefano F. Safety monitoring in the vaccine adverse event reporting system (VAERS). Vaccine. 2015;33(36):4398-4405. [CrossRef]
6. [6] Barrett S. Eradication versus control: The economics of global infectious disease policies. Bull World Health Organ. 2004;82:683–688.
7. [7] Bloom DE, Canning D, Weston M. The value of vaccination. World Econ. 2005;6(3):15–39.
8. [8] Lydon P, Beyai PL, Chaudhri I, Cakmak N, Satoulou A, Dumolard L. Government financing for health and specific national budget lines: the case of vaccines and immunization. Vaccine. 2008;26(51):6727–6734. [CrossRef]

9. [9] Widdowson MA, Meltzer MI, Zhang X, Bresee JS, Parashar UD, Glass RI. Cost-effectiveness and potential impact of rotavirus vaccination in the United States. Pediatrics. 2007;119(4):684–697. [CrossRef]
10. [10] Mayerova D, Abbas K. Childhood immunisation timeliness and vaccine confidence by health information source, maternal, socioeconomic, and geographic characteristics in Albania. BMC Public Health. 2021;21(1):1724. [CrossRef]
11. [11] Kalendari i vaksinimit, Departamenti i Epidemilogjisë dhe Kontrollit të sëmundjeve infektive, Instituti i Shëndetit Publik, 2017.