{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T15:54:17Z","timestamp":1790870057463,"version":"4.1.0"},"reference-count":57,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"COPAC\u2014Coalition of Organisations of Patients with Chronic Diseases in Romania"},{"name":"Active Citizenship Network"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Background\/Objectives: Immunisation coverage gaps in Central and Eastern Europe (CEE) are commonly attributed to barriers of access. This study measured how the professionals who deliver immunisation services weigh competing barriers, whether their assessments differ when the referent is their own country rather than the CEE region as a whole, and how they rank candidate interventions on expected impact and near-term feasibility. Methods: Sixty-two professionals working in twelve countries and at the European level (47 based in CEE, 39 of them in Romania) completed a cross-sectional structured survey around a multi-stakeholder meeting in Bucharest (14 May 2026). Respondents rated 15 barriers twice, for their own country and for the CEE region; rated 16 interventions for the expected impact and 12\u201324-month feasibility; force-ranked their selections; and assigned the lead responsibility for five system functions. Results: Digital misinformation was the highest-rated barrier in every subgroup and at both geographic levels. The assessments differed by geographic referent: within respondents, trust and information barriers were rated more severe for their own country and access barriers more severe for the region (d_z = 0.52), a pattern attenuated but retained after standardising within each level; the same regional object was also described differently by respondents inside and outside CEE (d = 1.02). Across the 16 intervention-level means, the expected impact and feasibility were only weakly and imprecisely associated (r = 0.21, 95% CI \u22120.32 to 0.64), although, within respondents, the two were modestly correlated (r = 0.33). Continuing professional education for primary care ranked first on expected impact and led the forced-choice ranking in every subgroup. The lead responsibility was the clearest for professional training and least settled for equity monitoring. Conclusions: Barriers were assessed differently depending on whether the referent was the respondent\u2019s own country or the region as a whole. These are professionals\u2019 perceptions, not measured outcomes: access may rank low partly because the panel does not face it personally, and the findings do not place cost and structural determinants second. Regional strategies built on assumptions about neighbouring systems may misallocate attention, and the equity agenda this panel endorses rests on a monitoring function no actor owns.<\/jats:p>","DOI":"10.3390\/vaccines14090819","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T14:45:10Z","timestamp":1790865910000},"page":"819","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Trust, Access, and the Division of Responsibility for Vaccine Confidence in Central and Eastern Europe: Paired Own-Country and Regional Ratings from a Multi-Stakeholder Professional Panel"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-6776-4709","authenticated-orcid":false,"given":"Teodor Cristian","family":"Blidaru","sequence":"first","affiliation":[{"name":"Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, Dionisie Lupu 37, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandru","family":"Rafila","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, Dionisie Lupu 37, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0768-5941","authenticated-orcid":false,"given":"Diana","family":"Nastas\u0103","sequence":"additional","affiliation":[{"name":"National Institute for Health Services Management, Vaselor 31, 021254 Bucharest, Romania"},{"name":"SMMR\u2014Romanian Multidisciplinary Society of Resident Physicians, Mihail Kog\u0103lniceanu 39, 050103 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Sinclair","sequence":"additional","affiliation":[{"name":"International Longevity Centre UK (ILC-UK), The Foundry, 17 Oval Way, London SE11 5RR, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petr","family":"Smejkal","sequence":"additional","affiliation":[{"name":"Department of Hygiene and Epidemiology, Institute for Clinical and Experimental Medicine (IKEM), V\u00edde\u0148sk\u00e1 1958\/9, 140 21 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7258-3434","authenticated-orcid":false,"given":"Yasmin","family":"Maor","sequence":"additional","affiliation":[{"name":"Infectious Disease Unit, E. Wolfson Medical Center, HaLochamim St. 62, Holon 5822012, Israel"},{"name":"Gray Faculty of Medical and Health Sciences, Tel Aviv University, Ramat Aviv, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7883-2427","authenticated-orcid":false,"given":"Ernest","family":"Kuchar","sequence":"additional","affiliation":[{"name":"Department of Paediatrics with Clinical Assessment Unit, Medical University of Warsaw, \u017bwirki i Wigury 63A, 02-091 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7557-2546","authenticated-orcid":false,"given":"Mariano","family":"Votta","sequence":"additional","affiliation":[{"name":"Active Citizenship Network\u2014Cittadinanzattiva, Via Imera 2, 00183 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lumini\u021ba","family":"V\u00e2lcea","sequence":"additional","affiliation":[{"name":"COPAC\u2014Coalition of Organisations of Patients with Chronic Diseases in Romania, Str. \u021aepe\u0219, Vod\u0103 22, 021525 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7819-5464","authenticated-orcid":false,"given":"Valeriu","family":"Gheorghi\u021b\u0103","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, Dionisie Lupu 37, 020021 Bucharest, Romania"},{"name":"\u201cProf. Dr. Agrippa Ionescu\u201d Clinical Emergency Hospital, Str. Arh. Ion Mincu 7, 011356 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"27041","DOI":"10.3402\/jmahp.v3.27041","article-title":"Vaccination: The Cornerstone of an Efficient Healthcare System","volume":"3","author":"Heckmann","year":"2015","journal-title":"J. Mark. Access Health Policy"},{"key":"ref_2","first-page":"3","article-title":"Povara financiar\u0103 a episoadelor de internare cu rujeol\u0103 \u00een Rom\u00e2nia 2023\u20132024 [The financial burden of measles hospitalisation episodes in Romania, 2023\u20132024]","volume":"29","year":"2025","journal-title":"Manag. Health"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Farina, S., Maio, A., Gualano, M.R., Ricciardi, W., and Villani, L. (2024). Childhood Mandatory Vaccinations: Current Situation in European Countries and Changes Occurred from 2014 to 2024. Vaccines, 12.","DOI":"10.3390\/vaccines12111296"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Alexander, C., Cabrera, M., Moore, M., and Lomazzi, M. (2023). Driving Paediatric Vaccine Recovery in Europe. Vaccines, 11.","DOI":"10.3390\/vaccines11010184"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1911","DOI":"10.2147\/RMHP.S519479","article-title":"Vaccine Hesitancy and Immunization Patterns in Central and Eastern Europe: Sociocultural, Economic, Political, and Digital Influences Across Seven Countries","volume":"18","author":"Kurpas","year":"2025","journal-title":"Risk Manag. Healthc. Policy"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1007\/s44197-025-00433-7","article-title":"Risk Analysis of Measles Outbreaks in Bulgaria and Romania for the Period 2000 to 2023: A Comparative Study","volume":"15","author":"Kounchev","year":"2025","journal-title":"J. Epidemiol. Glob. Health"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Stanescu, A., Ruta, S.M., Cernescu, C., and Pistol, A. (2024). Suboptimal MMR Vaccination Coverages\u2014A Constant Challenge for Measles Elimination in Romania. Vaccines, 12.","DOI":"10.3390\/vaccines12010107"},{"key":"ref_8","unstructured":"International Longevity Centre-UK (2024). Shifting the Narrative: Inspiring Increased Vaccine Confidence Across Central and Eastern Europe, ILC-UK. Available online: https:\/\/ilcuk.org.uk\/shifting-the-narrative\/."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Seweryn, M., Augusty\u0144ska, J., Kopel, J., Jaworski, R., W\u00f3jcik, A., Paradowska-Stankiewicz, I., and Czech, M. (2025). Public spending on immunisation in Poland. Front. Public Health, 13.","DOI":"10.3389\/fpubh.2025.1682169"},{"key":"ref_10","unstructured":"World Health Organization, and UNICEF (2026, July 14). WHO\/UNICEF Estimates of National Immunization Coverage (WUENIC), 2023 Revision, Available online: https:\/\/www.who.int\/teams\/immunization-vaccines-and-biologicals\/immunization-analysis-and-insights\/global-monitoring\/immunization-coverage\/who-unicef-estimates-of-national-immunization-coverage."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1097\/00005650-198102000-00001","article-title":"The concept of access: Definition and relationship to consumer satisfaction","volume":"19","author":"Penchansky","year":"1981","journal-title":"Med. Care"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1016\/S0140-6736(20)31558-0","article-title":"Mapping global trends in vaccine confidence and investigating barriers to vaccine uptake: A large-scale retrospective temporal modelling study","volume":"396","author":"Simas","year":"2020","journal-title":"Lancet"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"4161","DOI":"10.1016\/j.vaccine.2015.04.036","article-title":"Vaccine Hesitancy: Definition, Scope and Determinants","volume":"33","author":"MacDonald","year":"2015","journal-title":"Vaccine"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Costa-Font, J., Garcia-Hombrados, J., and Nici\u0144ska, A. (2023). The institutional origins of vaccines distrust: Evidence from former-Soviet countries. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0282420"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"127807","DOI":"10.1016\/j.vaccine.2025.127807","article-title":"Vaccine acceptance and refusal in Western and Central and Eastern European countries: An analysis based on the European Social Survey data from 23 countries, using a classification and regression tree","volume":"65","author":"Meler","year":"2025","journal-title":"Vaccine"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"590","DOI":"10.2105\/AJPH.2009.185652","article-title":"A Framework for Public Health Action: The Health Impact Pyramid","volume":"100","author":"Frieden","year":"2010","journal-title":"Am. J. Public Health"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Gaievskyi, S., Delfrate, N., Ragazzoni, L., and Bahattab, A. (2025). Use of multi-criteria decision analysis (MCDA) to support decision-making during health emergencies: A scoping review. Front. Public Health, 13.","DOI":"10.3389\/fpubh.2025.1584026"},{"key":"ref_18","unstructured":"Michie, S., Atkins, L., and West, R. (2014). The Behaviour Change Wheel: A Guide to Designing Interventions, Silverback Publishing."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1206","DOI":"10.1016\/j.vaccine.2014.12.020","article-title":"Conceptual frameworks and key dimensions to support coverage decisions for vaccines","volume":"33","author":"Piatti","year":"2015","journal-title":"Vaccine"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1007\/s10488-010-0319-7","article-title":"Outcomes for Implementation Research: Conceptual Distinctions, Measurement Challenges, and Research Agenda","volume":"38","author":"Proctor","year":"2011","journal-title":"Adm. Policy Ment. Health"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1186\/s13012-017-0635-3","article-title":"Psychometric assessment of three newly developed implementation outcome measures","volume":"12","author":"Weiner","year":"2017","journal-title":"Implement. Sci."},{"key":"ref_22","unstructured":"COPAC, Active Citizenship Network, and \u201cCarol Davila\u201d University of Medicine and Pharmacy (2025). Reducerea Decalajului de \u00cencredere: Consolidarea Vaccin\u0103rii Echitabile \u00een Europa Central\u0103 \u0219i de Est [Reducing the Confidence Gap: Strengthening Fair Vaccination in Central and Eastern Europe], COPAC. Available online: https:\/\/www.copac.ro\/reducerea-decalajului-de-incredere-consolidarea-vaccinarii-echitabile-in-europa-centrala-si-de-est\/."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Blidaru, T.C., Sinclair, D., Smejkal, P., Maor, Y., Kuchar, E., Weil-Olivier, C., Votta, M., V\u00e2lcea, L., and Gheorghi\u021b\u0103, V. (2026). From Confidence to Coverage: A Multi-Stakeholder Perspective on Vaccination in Central and Eastern Europe. Vaccines, 14.","DOI":"10.3390\/vaccines14080678"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1007\/BF00846146","article-title":"Unrealistic optimism about susceptibility to health problems: Conclusions from a community-wide sample","volume":"10","author":"Weinstein","year":"1987","journal-title":"J. Behav. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1207\/S15327957PSPR0501_5","article-title":"Do Moderators of the Optimistic Bias Affect Personal or Target Risk Estimates? A Review of the Literature","volume":"5","author":"Shepperd","year":"2001","journal-title":"Personal. Soc. Psychol. Rev."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jenvp.2008.06.001","article-title":"Temporal pessimism and spatial optimism in environmental assessments: An 18-nation study","volume":"29","author":"Gifford","year":"2009","journal-title":"J. Environ. Psychol."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Burgman, M.A., McBride, M., Ashton, R., Speirs-Bridge, A., Flander, L., Wintle, B., Fidler, F., Rumpff, L., and Twardy, C. (2011). Expert Status and Performance. PLoS ONE, 6.","DOI":"10.1371\/journal.pone.0022998"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"3179","DOI":"10.1007\/s11606-021-06737-1","article-title":"A Consensus-Based Checklist for Reporting of Survey Studies (CROSS)","volume":"36","author":"Sharma","year":"2021","journal-title":"J. Gen. Intern. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.1016\/j.jval.2024.07.027","article-title":"Recommendations on the Use of Structured Expert Elicitation Protocols for Healthcare Decision Making: A Good Practices Report of an ISPOR Task Force","volume":"27","author":"Soares","year":"2024","journal-title":"Value Health"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Gattrell, W.T., Logullo, P., van Zuuren, E.J., Price, A., Hughes, E.L., Blazey, P., Winchester, C.C., Tovey, D., Goldman, K., and Hungin, A.P. (2024). ACCORD (ACcurate COnsensus Reporting Document): A reporting guideline for consensus methods in biomedicine developed via a modified Delphi. PLoS Med., 21.","DOI":"10.1371\/journal.pmed.1004326"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1086\/268949","article-title":"The Measurement of Values in Surveys: A Comparison of Ratings and Rankings","volume":"49","author":"Alwin","year":"1985","journal-title":"Public Opin. Q."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1002\/j.1538-7305.1948.tb01338.x","article-title":"A Mathematical Theory of Communication","volume":"27","author":"Shannon","year":"1948","journal-title":"Bell Syst. Tech. J."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e70080","DOI":"10.1002\/acp.70080","article-title":"Spatial Optimism in Individuals\u2019 Future Thinking About the COVID-19 Pandemic","volume":"39","author":"Szpunar","year":"2025","journal-title":"Appl. Cogn. Psychol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1016\/S0140-6736(24)01340-0","article-title":"Peer learning in immunisation programmes","volume":"404","author":"Adamu","year":"2024","journal-title":"Lancet"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1177\/1529100618760521","article-title":"Increasing Vaccination: Putting Psychological Science into Action","volume":"18","author":"Brewer","year":"2017","journal-title":"Psychol. Sci. Public Interest"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Lin, C., Mullen, J., Smith, D., Kotarba, M., Kaplan, S.J., and Tu, P. (2021). Healthcare Providers\u2019 Vaccine Perceptions, Hesitancy, and Recommendation to Patients: A Systematic Review. Vaccines, 9.","DOI":"10.3390\/vaccines9070713"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Atwal, S., Schmider, J., Buchberger, B., Boshnakova, A., Cook, R., White, A., and El Bcheraoui, C. (2023). Prioritisation processes for programme implementation and evaluation in public health: A scoping review. Front. Public Health, 11.","DOI":"10.3389\/fpubh.2023.1106163"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e875","DOI":"10.1002\/hpja.875","article-title":"Evidence gaps and challenges in maintaining and increasing vaccine uptake: A Delphi survey with Australian stakeholders","volume":"36","author":"Robinson","year":"2025","journal-title":"Health Promot. J. Austr."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1429","DOI":"10.1080\/14760584.2022.2104715","article-title":"A scoping review of literature exploring factors affecting vaccine uptake within Roma communities across Europe","volume":"21","author":"Cronin","year":"2022","journal-title":"Expert Rev. Vaccines"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"S\u00e1ndor, J., Vincze, F., Shrikant, M.L., K\u0151r\u00f6si, L., Ulicska, L., K\u00f3sa, K., and \u00c1d\u00e1ny, R. (2022). COVID-19 vaccination coverage in deprived populations living in segregated colonies: A nationwide cross-sectional study in Hungary. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0264363"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e254","DOI":"10.1016\/S1473-3099(22)00066-4","article-title":"Defining the determinants of vaccine uptake and undervaccination in migrant populations in Europe to improve routine and COVID-19 vaccine uptake: A systematic review","volume":"22","author":"Crawshaw","year":"2022","journal-title":"Lancet Infect. Dis."},{"key":"ref_42","first-page":"CD004015","article-title":"Lay health workers in primary and community health care for maternal and child health and the management of infectious diseases","volume":"2010","author":"Lewin","year":"2010","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e49695","DOI":"10.2196\/49695","article-title":"Community Engagement in Vaccination Promotion: Systematic Review and Meta-Analysis","volume":"10","author":"Xie","year":"2024","journal-title":"JMIR Public Health Surveill."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"105","DOI":"10.3167\/ajec.2024.330110","article-title":"Roma Community and Health Inequalities during the COVID-19 Pandemic in Romania","volume":"33","author":"Budian","year":"2024","journal-title":"Anthropol. J. Eur. Cult."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e071852","DOI":"10.1136\/bmjopen-2023-071852","article-title":"Evaluating the impact of using mobile vaccination units to increase COVID-19 vaccination uptake in Cheshire and Merseyside, UK: A synthetic control analysis","volume":"13","author":"Zhang","year":"2023","journal-title":"BMJ Open"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"2300503","DOI":"10.2807\/1560-7917.ES.2024.29.34.2300503","article-title":"Mobile vaccination units to increase COVID-19 vaccination uptake in areas with lower coverage: A within-neighbourhood analysis using national registration data, the Netherlands, September\u2013December 2021","volume":"29","author":"Lambooij","year":"2024","journal-title":"Eurosurveillance"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"e140361","DOI":"10.3897\/folmed.67.e140361","article-title":"Vaccination Coverage of Roma Children, and Barriers and Attitudes of Roma Parents","volume":"67","author":"Stilianesi","year":"2025","journal-title":"Folia Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1136\/jech-2025-225099","article-title":"Improving Childhood Vaccination among Minority Populations in Middle- and High-Income Countries: A Realist Review of Health System Interventions","volume":"80","author":"Gorelik","year":"2026","journal-title":"J. Epidemiol. Community Health"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"7439","DOI":"10.1016\/j.vaccine.2018.10.058","article-title":"Conflicts of interest and the (in)dependence of experts advising government on immunization policies","volume":"36","author":"Ringuette","year":"2018","journal-title":"Vaccine"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1056\/NEJMsr1610625","article-title":"Conflicts of Interest for Patient-Advocacy Organizations","volume":"376","author":"McCoy","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Bergen, N., Johns, N.E., Blanc, D.C., and Hosseinpoor, A.R. (2023). Within-Country Inequality in COVID-19 Vaccination Coverage: A Scoping Review of Academic Literature. Vaccines, 11.","DOI":"10.3390\/vaccines11030517"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Jaca, A., and Mathebula, L. (2026). Integrating Health Inequality Monitoring and Equity-Focused Policy Analysis for Immunization: A Conceptual Framework for Translating Data into Equity-Oriented Action. Vaccines, 14.","DOI":"10.20944\/preprints202602.0287.v1"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Chiavarini, M., Bechini, A., Boccalini, S., Barash, A., Castellana, E., Senape, A., and Bonanni, P. (2025). Vaccination Against Herpes Zoster in Adults: Current Strategies in European Union Countries. Vaccines, 13.","DOI":"10.3390\/vaccines13101073"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1007\/s00103-019-03063-0","article-title":"Understanding Vaccine Acceptance and Demand\u2014And Ways to Increase Them","volume":"63","author":"Habersaat","year":"2020","journal-title":"Bundesgesundheitsblatt Gesundheitsforsch. Gesundheitsschutz"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1146\/annurev-publhealth-090419-102240","article-title":"Vaccine Hesitancy, Acceptance, and Anti-Vaccination: Trends and Future Prospects for Public Health","volume":"42","author":"Ward","year":"2021","journal-title":"Annu. Rev. Public Health"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1662","DOI":"10.1001\/archinte.164.15.1662","article-title":"Clinicians\u2019 Perceptions of the Problem of Antimicrobial Resistance in Health Care Facilities","volume":"164","author":"Giblin","year":"2004","journal-title":"Arch. Intern. Med."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"ofaa244","DOI":"10.1093\/ofid\/ofaa244","article-title":"Primary Care Physicians\u2019 Attitudes and Perceptions towards Antibiotic Resistance and Antibiotic Stewardship: A National Survey","volume":"7","author":"Zetts","year":"2020","journal-title":"Open Forum Infect. Dis."}],"container-title":["Vaccines"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-393X\/14\/9\/819\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T14:54:33Z","timestamp":1790866473000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-393X\/14\/9\/819"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,17]]},"references-count":57,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["vaccines14090819"],"URL":"https:\/\/doi.org\/10.3390\/vaccines14090819","relation":{},"ISSN":["2076-393X"],"issn-type":[{"value":"2076-393X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,17]]}}}