Childhood vaccination in Roma communities

Chișinău, 2 February 2026 – The findings of a study examining the factors influencing childhood vaccination in Roma communities in the Republic of Moldova were presented today at an event organized by the Ministry of Health and UNICEF. The study shows that under-immunization among Roma children is not driven by anti-vaccination attitudes, but rather by systemic factors such as exclusion, discrimination, and communication gaps in interactions with the health system.

The study was conducted over an eight-month period in 2025 in the localities of Soroca and Otaci, in partnership with the Tarna Rom Organization, using a participatory qualitative research methodology grounded in behavioral science and human-centered design. The research included 12 focus group discussions and 30 in-depth interviews with Roma families, healthcare workers, community mediators, and local leaders, as well as participatory workshops dedicated to identifying solutions.

The findings indicate that Roma families generally trust medicine and recognize the importance of vaccination. However, repeated negative experiences often lead to delays in or avoidance of childhood vaccination.

The study identified six critical barriers influencing vaccination decisions:

• lack of trust resulting from negative interactions with healthcare workers;
• misinformation and the absence of linguistically and culturally adapted information;
• discrimination and care perceived as disrespectful;
• the influence of family hierarchies in decision-making processes;
• logistical barriers and frequent family mobility;
• the underutilized role of Roma community mediators.

“Equitable immunization coverage is a core objective of the National Immunization Programme. Applying evidence-based interventions, including social and behavioral change approaches, allows us to reduce access inequities and respond more effectively to the needs of vulnerable groups,” said Angela Paraschiv, State Secretary of the Ministry of Health.

More than 70 specialists attended the presentation of the study findings, including representatives of the Ministry of Health, the National Agency for Public Health, healthcare institutions, Roma community mediators, non-governmental organizations, public health and education experts, as well as development partners.

Based on the findings, the study proposes three integrated interventions, co-developed with members of Roma communities and local stakeholders:

• family health circles, providing safe spaces for dialogue, information, and support for mothers;
• adapting the operating schedules of medical facilities to the needs of Roma communities, through dedicated time slots, empathetic communication, and child-friendly environments;
• strengthening the role of community mediators through their formal integration into vaccination information, follow-up, and reminder processes.

“When trust erodes, immunization coverage declines. For Roma communities, this challenge is even deeper. It is not only about trust, but about access—access to respectful services and to a system that treats them as equal users, not as exceptions. Increasing vaccination coverage is not about persuading parents more forcefully; it is about rebuilding trust and removing access barriers. And trust cannot be demanded. It must be demonstrated—interaction by interaction,” said Maha Damaj, UNICEF Representative in the Republic of Moldova.

“For Tarna Rom, change starts within the community. Our strategy focuses on shared ownership of solutions, respect for Roma cultural identity, and the elimination of discrimination, so that Roma communities can benefit from the same opportunities as all other groups,” emphasized Marin Alla, President of Tarna Rom Organization.

The Ministry of Health and UNICEF, together with partner organizations, will explore opportunities to pilot the proposed interventions and integrate them into national efforts to increase immunization coverage, with a strong focus on equity, respect, and inclusion. The study is implemented as part of the Immunization Social and Behavioral Change Plan 2027.

Vaccination coverage rates in the Republic of Moldova have fallen below the recommended threshold of 95%, increasing the risk of outbreaks of vaccine-preventable diseases. Compared to 2023, vaccination coverage declined by approximately 1% in 2024 and by nearly 5% compared to pre-pandemic levels in 2019. In 2024, coverage reached 86.7% for DTP, 87.3% for polio, and 83.9% for MMR.

The study is available here in Romanian.