Introduction: Improving adult pneumococcal vaccination is a public-health priority in Romania, and evidence regarding patient-level outcomes following different approaches to physician training remains limited. Materials and methods: This non-randomised, multicentre, quasi-experimental implementation study examined patient-level changes across three geographically distinct Romanian settings between August and November 2025. Physicians in Iași and Dolj counties received in-person training combining medical content with communication techniques based on motivational interviewing, whereas physicians in the webinar group received online medical training without a dedicated communication module. Eligible adult patients completed questionnaires before and after counselling and reported whether they had been vaccinated or had scheduled a vaccination appointment. Results: The analysis included 295 questionnaire pairs from patients nested within 29 physicians. Baseline attitudes differed markedly across settings (composite score of 5.64 in the webinar group, 5.29 in Dolj County, and 4.09 in Iași County; p < 0.001), as did strong baseline vaccination intention (75.6%, 48.1%, and 27.2%, respectively). Using a composite score comprising all seven attitude items, with item 7 reverse-coded and vaccination intention analysed separately, the cluster-robust group-by-time model indicated different mean changes between settings (global p = 0.001): +0.28 in the webinar group, +1.02 in Iași, and +0.60 in Dolj. Strong vaccination intention increased within each setting, but the magnitude of change did not differ between settings (group-by-time p = 0.929). The combined self-reported vaccination-or-scheduling outcome was observed in 81.5% of patients in the webinar group, 49.4% in Iași, and 73.3% in Dolj; after adjustment for baseline intention, there was no longer evidence of an overall group difference (p = 0.651). Discussion and conclusions: Because training approach, delivery modality, geographical setting, physician cohort, and patient population were not independently allocated, and because baseline levels differed markedly between settings, the findings should be interpreted as exploratory implementation patterns rather than causal comparative effects.

Background/Objectives: Motivational interviewing (MI) is an established approach to addressing vaccine hesitancy, yet immediate changes following dedicated training for family physicians remain insufficiently documented in Romania. This study evaluated pre–post changes in physicians’ MI knowledge, self-reported communication behaviour, and self-perceived ability to counsel patients about vaccination, together with patient-level change following consultations delivered by trained physicians. Methods: This uncontrolled pre–post study used a voluntary, self-selected non-probability sample of 28 family physicians recruited through announcements distributed via county family medicine associations; participants completed paired assessments immediately before and after structured MI-based training. The three main physician-level outcomes were MI knowledge (MISI), corrected self-reported MI communication behaviour (MIBI), and self-perceived MI ability (SPMI). The linked component comprised 151 patients nested within 15 physicians. Patient changes were averaged within physician, and the physician-level mean patient composite change was used as the principal outcome of this component. Paired physician changes and physician-aggregated patient change were assessed using Wilcoxon tests, rank-biserial effect sizes, and bootstrap 95% confidence intervals (CIs), with Holm adjustment across the three physician outcomes. Results: Mean MISI increased by 39.80 percentage points (95% CI: 29.59–50.51), though the limited internal consistency of this seven-item composite requires item-level interpretation, and corrected MIBI by 0.44 points (95% CI: 0.20–0.68; r_rb = 0.75) and SPMI by 1.22 points (95% CI: 0.89–1.61; r_rb = 0.99); all Holm-adjusted p-values were <0.001. Across the 15 linked physicians, the mean patient composite change was 0.55 points (95% CI: 0.38–0.75; r_rb = 1.00; p < 0.001). No consistent association was observed between physician-level competency changes and mean patient change. Conclusions: Immediate post-training physician scores and post-consultation patient composite scores were higher. Controlled studies incorporating observed consultations and follow-up are required before causal or sustained effects can be inferred.

The use of immunosuppressive or immunomodulatory the­ra­pies in various pathologies leads to a major risk of in­fec­tions, representing a significant cause of morbidity and mor­ta­lity for these patients. In structuring the preventive stra­te­gy, characterizing the pathology that motivates the im­mu­no­sup­pres­sion, understanding the mechanism of ac­tion of the immunosuppressant, evaluating previous in­fec­tions, recognizing risk factors, performing laboratory scre­enings, administering vaccines, educating the pa­tient, and monitoring clinical symptoms and signs are es­sen­tial, depending on necessarily individualized clinical ma­nage­ment. Vaccination, as a strategy for preventing in­fec­tions, in children and adults, plays a crucial role in im­mu­no­com­pro­mised individuals. The CDC and ECDC guidelines spe­cify which vaccines are recommended for patients with com­pro­mised immunity. Nationally, the Ministry of Health has adopted these recommendations and established the vac­cines and the method of compensation for this category of patients.

Background and Objectives: Family physicians are central to HPV vaccination delivery in Romania, yet little is known about how they perceive recent changes in parental attitudes and the barriers encountered in routine practice. We described these perceptions and examined factors associated with reporting a perceived change. Materials and Methods: A cross-sectional online survey of a non-probability convenience sample of 525 primary-care physicians was conducted in February 2025. Closed responses were summarised descriptively, free-text responses underwent structured thematic content analysis, and robust Poisson regression estimated adjusted prevalence ratios (aPRs), with nominal inference. Results: Amongst respondents, 82.9% reported perceiving a change in parental attitudes; 67.4% provided content meeting a conservative favourable-coding definition and 76.8% a broader definition. Safety concerns and fear (51.9%) and distrust or resistance (46.8%) were the most frequent barriers. Digital sources were perceived as the principal origins of myths (95.6%). Urban respondents reported perceived change more often than rural respondents (88.2% versus 69.9%; aPR 1.265, 95% CI 1.133–1.413; p < 0.001), with similar estimates across sensitivity analyses. Conclusions: In this convenience sample, most physicians reported perceiving changes in parental attitudes and many descriptions were coded as favourable. These reports generate hypotheses for studies using direct parental measures and documented vaccination outcomes.