Published online October 1, 2008
PEDIATRICS Vol. 122 No. 4 October 2008, pp. 718-725 (doi:10.1542/peds.2007-0538)
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ARTICLE

Parents With Doubts About Vaccines: Which Vaccines and Reasons Why

Deborah A. Gust, PhD, MPHa, Natalie Darling, MPHa, Allison Kennedy, MPHa and Ben Schwartz, MD, MPHb

a National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
b National Vaccine Program Office, Washington, DC

OBJECTIVES. The goals were (1) to obtain national estimates of the proportions of parents with indicators of vaccine doubt, (2) to identify factors associated with those parents, compared with parents reporting no vaccine doubt indicators, (3) to identify the specific vaccines that prompted doubt and the reasons why, and (4) to describe the main reasons parents changed their minds about delaying or refusing a vaccine for their child.

METHODS. Data were from the National Immunization Survey (2003–2004). Groups included parents who ever got a vaccination for their child although they were not sure it was the best thing to do ("unsure"), delayed a vaccination for their child ("delayed"), or decided not to have their child get a vaccination ("refused").

RESULTS. A total of 3924 interviews were completed. Response rates were 57.9% in 2003 and 65.0% in 2004. Twenty-eight percent of parents responded yes to ever experiencing ≥1 of the outcome measures listed above. In separate analyses for each outcome measure, vaccine safety concern was a predictor for unsure, refused, and delayed parents. The largest proportions of unsure and refused parents chose varicella vaccine as the vaccine prompting their concern, whereas delayed parents most often reported "not a specific vaccine" as the vaccine prompting their concern. Most parents who delayed vaccines for their child did so for reasons related to their child's illness, unlike the unsure and refused parents. The largest proportion of parents who changed their minds about delaying or not getting a vaccination for their child listed "information or assurances from health care provider" as the main reason.

CONCLUSIONS. Parents who exhibit doubts about immunizations are not all the same. This research suggests encouraging children's health care providers to solicit questions about vaccines, to establish a trusting relationship, and to provide appropriate educational materials to parents.

Key Words: parents • vaccine concern • doubt • refusal • delay • unsure

Abbreviations: NIS—National Immunization Survey

Accepted Dec 21, 2007.


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