Background
Parental concerns about immunization safety have been covered widely in the media
and on the Internet and have been correlated in some studies with under-immunization
and the late receipt of immunizations.
Objectives
Phase 1: To (1) measure the prevalence of parents with immunization safety concern,
specifically those with high-level concern, (2) determine demographic characteristics
and attitudes typical for this subgroup of parents, and (3) determine factors that
influence such parents, nevertheless, to have their children immunized. Phase 2: To
further explore the racial/ethnic difference found in the first-phase results, specifically
to compare the immunization attitudes of Hispanic (both black and white) and non-Hispanic
black parents with those of non-Hispanic white parents.
Methods
ConsumerStyles (2004) survey data of a nationwide panel of U.S. adults were analyzed
in January 2006. In Phase 1, bivariate and logistic regression analyses were used
to identify factors associated with parental concerns about immunization safety. In
Phase 2, logistic regression was used to compare immunization attitudes among non-Hispanic
black; Hispanic (both black and white); and non-Hispanic white parents.
Results
The response rate was 62% (6207/10,000); analysis was restricted to the 2937 (47%)
respondents who were parents with a child aged 18 years or younger; 634 (21%) responded
with the highest level of concern, 5 on a 1-to-5-point scale. Demographics (Hispanic
ethnicity/nonwhite race, low income, and less education) and negative attitudes toward
immunization and the child’s healthcare provider were significantly associated with
high-level concern. Seventy-two percent of parents with high-level concern responded
that the risk of a child getting a disease was their primary reason for having their
child immunized, while 17% listed state laws requiring immunizations for school/daycare
entry. Importantly, black parents were more likely than white parents to have negative
attitudes toward immunizations and their child’s healthcare provider.
Conclusions
One fifth of parents reported high-level concern with the safety of childhood immunizations.
To prevent the erosion of childhood immunization rates, healthcare providers need
to learn how to recognize and address these concerns.
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References
- Under-immunization among children.Pediatrics. 2004; 114: e16-e22
- Why do parents decide against immunization? The effect of health beliefs and health professionals.Child Care Health Dev. 2003; 29: 303-311
- Impact of anti-vaccine movements on pertussis control.Lancet. 1998; 351: 356-361
- Parental vaccine safety concerns.Am J Prev Med. 2005; 28: 221-224
- Factors associated with refusal of childhood vaccines among parents of school-aged children.Arch Pediatr Adolesc Med. 2005; 159: 470-476
- The relation of parent and provider characteristics to vaccination status of children in private practices and managed care organizations in Maryland.Med Care. 1999; 37: 44-55
- The association between parental health beliefs and immunization status among children followed by private pediatricians.Clin Pediatr (Phila). 1996; 35: 18-22
- Parental attitudes do not explain under-immunization.Pediatrics. 1996; 98: 1076-1083
- Parental vaccine safety concerns. The experiences of pediatricians and family physicians.Am J Prev Med. 2004; 26: 11-14
- Vaccine risks.Vaccine. 1999; 17: S41-S46
- Anti-vaccination activists on the world wide web.Arch Dis Child. 2002; 87: 22-25
- Content and design attributes of anti-vaccination web sites.JAMA. 2002; 287: 3245-3248
- Vaccine criticism on the world wide web.J Med Internet Res. 2005; 7: e17
- Do parents understand immunizations? A national telephone survey.Pediatrics. 2000; 106: 1097-1102
- Factors influencing African-American mothers’ concerns about immunization safety.J Natl Med Assoc. 2005; 97: 657-666
- A qualitative investigation of vaccine risk perception amongst parents who immunize their children.J Public Health Med. 2003; 25: 161-164
- Immunization attitudes and beliefs among parents.Am J Health Behav. 2005; 29: 81-92
- Mixed methods research.Educ Researcher. 2004; 33: 14-26
- Weber D. ConsumerStyles 2005 survey. Porter Novelli, Washington DC2005
- Weber D. Styles 2003 methodology. Porter Novelli, Washington DC2003
- Parent attitudes toward immunizations and healthcare providers the role of information.Am J Prev Med. 2005; 29: 105-112
- Vaccine beliefs of parents who oppose compulsory vaccination.Public Health Rep. 2005; 120: 252-258
- Current Population Survey. U.S. Census Bureau, Washington DC2003 (C2-C03-ALLF-02-US1)
- Behavioral Risk Factor Surveillance System survey questionnaire. U.S. Department of Health and Human Services, Atlanta GA2002
- 2002: 2120-2124 (American Statistical Association 2002 Proceedings, section on health policy statistics, New York) Use of consumer panel survey data for public health communication planning an evaluation of survey results.
- Immunization status and sociodemographic characteristics.Am J Public Health. 1998; 88: 1821-1826
- Barriers to immunization and missed opportunities.Pediatr Ann. 1998; 27: 366-374
- Children’s access to primary care.Pediatrics. 1996; 97: 26-32
- Personal, financial, and structural barriers to immunization in socioeconomically disadvantaged urban children.Pediatrics. 1998; 101: 591-596
- Distrust, race, and research.Arch Intern Med. 2002; 162: 2458-2463
- Under the shadow of Tuskegee.Am J Public Health. 1997; 87: 1773-1778
- The role of trust in use of preventive services among low-income African-American women.Prev Med. 2004; 38: 777-785
- Joint statement concerning removal of thimerosal from vaccines. U.S. Public Health Service, Washington DC2000 (June 22)
- Immunization safety review. National Academy Press, Washington DC2004
- The health belief model.Health Educ Q. 1984; 11: 1-47
- The immunization system in the United States.Vaccine. 1999; 17: S19-S24
- Knowledge, attitudes, and beliefs of school nurses and personnel and associations with nonmedical immunization exemptions.Pediatrics. 2004; 113: e552-e559
- Childhood immunization refusal.Fam Med. 2004; 36: 431-439
- Response errors in surveys of children’s immunizations.Vital Health Stat. 1999; 6: 8
- National, state, and urban area vaccination coverage among children aged 19–35 months—United States, 2003.MMWR Morb Mortal Wkly Rep. 2004; 53: 658-661
Article Info
Publication History
Published online: July 14, 2006
Footnotes
At the time of the study, IMS was a research fellow with the Association of Schools of Public Health, Washington DC.
Identification
Copyright
© 2006 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.