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Table 3 List of reported factors (beliefs, attitudes and reasons) regarding vaccination and vaccine preventable diseases (VPD) among the five identified UVGs. The numbers stand for the number of times a certain factor was mentioned in the articles found for each UVG

From: Under-vaccinated groups in Europe and their beliefs, attitudes and reasons for non-vaccination; two systematic reviews

  Orthodox Protestants (1 study) Anthroposophists (2 studies) Roma (5 studies) Irish Travelers (4 studies) Orthodox Jewish (2 studies)
Perceived severity/susceptibility of VPD
 Perceived non-severity of VPD:      
  - some VPD are not severe (e.g. not severe: measles, mumps, pertussis; severe: tetanus, polio and diphtheria) 1 1   1  
  - some VPD are helpful for child’s development (e.g. measles)   2   1  
 Perceived non-susceptibility to VPD (e.g. only a small number of children with VPD disease)   1    
Perceived safety/effectiveness of vaccine
 Perceived un-safety of the vaccine (adverse events, misconceptions) 1 1   2 1
 Perceived non-effectiveness of the vaccine (e.g. graphs and reports do not prove effectiveness of the vaccines)   2    
 Beliefs about vaccine (components of the vaccine could be dangerous e.g. poisons, toxins, contaminants)   1    1
Flexibility / freedom
 Adapting vaccination schedule to the child (schedule not flexible enough)   1    
 Combined vaccines should be monovalent (parents like to choose, parents perceive overload of antigens of various diseases in combination vaccine)   1    
Knowledge
 Need for more information or lack of information (e.g. risk of vaccination / scientific facts from the Public Health authorities, where and when to vaccinate)   1 1 2 1
 Low awareness of vaccination as a preventive measure    1   
Social networks (parents heard term MMR linked with fears)      1
Ideas about prevention
 Anthroposophic (healthy lifestyle, confidence in the health of the child, freedom of choice in healthcare and natural remedies, let the body experience certain infections)   2    
 Complementary medicine being unavailable      1
 Religious beliefs (trust in God) 1     1
Social structural aspects
 Socio-economic and cultural differences (e.g. language barriers, improper housing, low level of formal education, illiteracy)    4 3  
 Improvement in access and facilities for their children (e.g. limited and inflexible clinic hours)      1
 Poor access to health care centres (e.g. high spatial mobility for Roma and Irish Travellers)    4 3  
 Exposure to stigmatization, marginalization and discrimination    3 3  
 No trust in information from the Public Health authorities   1   1