Evidence map›Paper›PMID 42042775›Full record

ReviewVaccines2026

Vaccine Confidence and Vaccine Hesitancy in Several Countries in Southeastern Europe in Past 10 Years: A Structured Review of Published Literature.

Kaja Damnjanović, Kalin Djurov, Matea Galic, Bogdan Lisul, Ionut Viorel Mocanu, Shreya Shukla, Ashley Enstone, Lisa Dai, Mitja Vrdelja, Hristiana Batselova and 2 more

Abstract readReview
In one paragraph

Review in Vaccines, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Kaja DamnjanovićDepartment of Psychology, University of Belgrade, 11000 Belgrade, Serbia.ORCID 0000-0002-9254-1263
Kalin DjurovMSD Bulgaria, 55 Nikola Vaptzarov Blvd.,1407 Sofia, Bulgaria.
Matea GalicMSD Croatia, 10010 Zagreb, Croatia.
Bogdan LisulMSD Serbia, 11070 Belgrade, Serbia.
Ionut Viorel MocanuMSD Romania, 013704 Bucharest, Romania.
Shreya ShuklaAdelphi Values PROVE, Bollington SK10 5JB, UK.
Ashley EnstoneAdelphi Values PROVE, Bollington SK10 5JB, UK.
Lisa DaiAdelphi Values PROVE, Bollington SK10 5JB, UK.
Mitja VrdeljaNational Institute of Public Health, 1000 Ljubljana, Slovenia.ORCID 0000-0003-2486-9053
Hristiana BatselovaDepartment of Epidemiology and Disaster Medicine, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria.ORCID 0000-0002-6201-848X
Anca DrăgănescuNational Institute for Infectious Diseases, 050463 Bucharest, Romania.
Goran TešovićPediatric Infectious Diseases Department, University Hospital for Infectious Diseases, University of Zagreb, School of Medicine, 10000 Zagreb, Croatia.ORCID 0000-0002-5153-5027

Funding

Merck Sharp & Dohme LLC N/A
6 · The paper itself

Abstract

objectivesDespite vaccination being the most effective way of preventing infections and vaccination rates recovering worldwide after the COVID-19 pandemic, vaccine hesitancy persists. Some factors, such as psychological and social barriers, can negatively impact views on vaccines and can contribute to vaccine hesitancy. The primary objective of this structured literature review is to investigate the available evidence relating to factors affecting vaccine hesitancy within several countries in Southeastern Europe.

methodsAn electronic database search was conducted to identify studies assessing the public and healthcare professionals' (HCPs) attitudes towards vaccination in Southeastern Europe. These searches were supplemented with grey literature searches. Included studies were conducted in Bulgaria, Croatia, Romania, Serbia, and Slovenia between 1 January 2012 and 31 December 2022.

resultsOf the 35 studies identified from the database searches, the most prominent theme observed across Romania, Croatia, and Bulgaria was low confidence in COVID-19 vaccines. Across all age groups, COVID-19 vaccine confidence in these regions was highly dependent on whether individuals thought vaccines were safe and effective, as well as their general trust in vaccines. Confidence in COVID-19 vaccines was seen as relatively high, with attitudes towards routine and elective vaccines being generally positive amongst the general public and HCPs, in Romania, Croatia, Serbia and Slovenia. However, uncertainty around the effectiveness of the vaccine still exists. In Bulgaria, trust in routine and elective vaccines remained low in the general public. Complacency and financial constraints were also identified as underlying causes of vaccine hesitancy.

conclusionsThe main cause behind vaccine hesitancy in several countries in Southeastern Europe is distrust in vaccine effectiveness and safety. These key findings can be utilised to support evidence-based decisions regarding where to focus resources to improve public and HCP perception of vaccines in Southeastern Europe.

Indexed as

barriers to vaccinationconfidenceimpact of COVID-19Southeastern Europetrust in vaccinesvaccine hesitancy

Identifiers

PMID42042775
PMCPMC13120427

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.