Elsevier

Vaccine

Volume 23, Issue 19, 31 March 2005, Pages 2486-2493
Vaccine

Confidence in vaccination: a parent model

https://doi.org/10.1016/j.vaccine.2004.10.026Get rights and content

Abstract

Although vaccination has been heralded as one of the 10 greatest public health achievements, how parents differ in their views about vaccination is not well understood. A deeper understanding of these attitudes and beliefs may improve the effectiveness of vaccine communications. In this mailed survey of U.S. parents in January 2001 (return response rate 49%), parental confidence in vaccination was very high, although there was significant variation among parents. Using multivariate analyses to group and profile parents, 90% of parents (n = 1820) were classified into one of four distinct parent groups: (1) “Vaccine Believer” parents who were convinced of the benefit of vaccination; (2) “Cautious” parents noteworthy for a high emotional investment in their child; (3) “Relaxed” parents characterized by a less involved parenting style and some skepticism about vaccines; and (4) “Unconvinced” parents distinguished by their distrust of vaccinations and vaccination policy. These findings suggest that messages that are customized to parents’ attitudes and beliefs may improve their understanding and acceptance of vaccination.

Introduction

Vaccination is often lauded as one of the ten greatest public health achievements in the last century [1]. In the U.S., vaccination rates have reached near all-time high levels [2], while the incidence of vaccine preventable disease has diminished to record lows [3]. Despite this remarkable legacy, controversies about vaccines and vaccination policy, while not new [4], still flourish. The genesis of concerns about vaccines has been broadly reviewed in the literature, and it appears that a confluence of events and perceptions are fueling the centuries old debate about the safety of vaccines [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17].

First, to an increasing number of healthcare providers and parents, vaccine preventable diseases are but a distant memory, of which they have little to no first hand experience. This lack of experience combined with the proliferation of negative vaccine messages in the media, the Internet and Congress, raises doubt among some members of the public about the necessity or benefits of vaccines. Alternative medical beliefs, many of which possess negative views of vaccines, have also become more popular. Finally, some individuals and groups have expressed distrust of governmental agencies or other experts that establish U.S. vaccination policy.

To help counter these concerns and improve risk communications about vaccines, many policy makers have suggested the need for additional research to better understand how parents make vaccine decisions for their children [13], [18]. We conducted a national mail survey of parents to ascertain prevailing attitudes, beliefs and behaviors about vaccination and to determine whether differences in attitudes and beliefs exist that could be used to improve vaccine communications.

Section snippets

Material and method

A mail study was completed in January 2001 by Ipsos Health, a market research supplier, among parents of children under the age of 16, drawn from the Home Testing Institute (HTI) consumer panel. This panel is maintained by Ipsos Health and used for proprietary market research across a number of different industries. The panel was constructed to match the U.S. Census on demographic and geographic variables including household size, household income, age of head of household, socioeconomic status

Results

Overall, 2018 parents (of 4115) returned the survey, yielding a return rate of 49%. Parents from the sub-sample, youngest child under seven years of age returned 1079 surveys (2105 were sent), a 51% response rate. The second sub-sample consisting of parents with youngest child between 10 and 15 years of age returned 451 surveys (842 were sent), a response rate of 54%. The third sub-sample of parents who were African Americans and English-speaking Hispanics returned 488 surveys (1168 were sent),

Discussion

Our findings demonstrate that overall parent confidence in vaccines remains high; the majority of parents believe vaccinations are very important and generally safe. Findings were similar to the research conducted by the National Network for Immunization Information (NNII) in mid 1999, although the methodologies differed. In the earlier research, 86.9% of parents deemed vaccinations as extremely important versus 89% in our study. Likewise, in the 1999 NNII study, parents assigned vaccines an

Conclusions

We have confirmed prior research [29], [30], [31] that parents continue to rely on their healthcare providers as the primary, most credible source about vaccination and provider recommendations carry substantial influence with parents. Our research quantified the divergent parental attitudes, beliefs and behaviors regarding vaccinations and uniquely identified and profiled four distinct parent groups. Because parents are not homogeneous in their vaccine attitudes and the factors that influence

Acknowledgment

This project was funded by the Merck Vaccine Division.

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    1

    Formerly from the Merck Vaccine Division.

    2

    Retired.

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