Causes for Deficient Coverage of MMR Vaccine in the Balkan States and the Way Forward

Objectives: To evaluate the causes for low MMR vaccination coverage in the 9 Balkan States, and provide solutions for this public health concern. Methods: Credible articles published 5 years ago, from 2012 up to date were sought for, to ascertain and analyze information on the cause for low MMR vaccine coverage in the Balkan States, and also to provide strategies for mitigation. These journals were sought for in the following reference libraries available online: PubMed, EMBASE, CAB Abstracts, the World Health Organization, the Cochrane Library, Popline, European Centre for Disease Prevention and Control, Centre for Disease and Control, and Google/Google Scholar. Results: This study evaluated MMR vaccinations in nine Balkan States (Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Macedonia, Montenegro, Slovenia, Serbia and Romania) from 2012 to 2016. While Albania ranked highest in maintaining the WHO recommended 95% vaccination coverage, other states fluctuated in their percentage of coverage with Bosnia and Herzegovina, Serbia, and Romania having the lowest coverage respectively. Conclusion: Socio-economic and Administrative factors have been the major challenge affecting MMR vaccination coverage in the Balkan States. Anti-vaccination movements recently increased their influence by encouraging the rejection of vaccination by parents. To curb these challenges, research institutes and governmental agencies should sensitize the society about the benefits of vaccination in children and further publicize clinical trials of vaccines in order to prove their safety and efficacy to the public. Keywords: MMR vaccination, vaccine coverage, measles, public health