Changes in childhood immunization decisions in the United States: Results from 2012 & 2014 National Parental Surveys

Abstract

Objective Understanding the current status of parents’ vaccine decision making is crucial to inform public policy. We sought to assess changes in vaccine decisions among parents of young children. Methods We conducted a web-based national poll of parents of children <7 years in 2012 and 2014. Participants reported vaccine decisions for their youngest child. We calculated survey-weighted population estimates of overall immunizations decisions, and delay/refusal rates for specific vaccines. Results In 2012, 89.2% (95% CI, 87.3–90.8%) reported accepting or planning to accept all recommended non-influenza childhood vaccines, 5.5% (4.5–6.6%) reported intentionally delaying one or more, and 5.4% (4.1–6.9%) reported refusing one or more vaccines. In 2014, the acceptance, delay, and refusal rates were 90.8% (89.3–92.1%), 5.6% (4.6–6.9%), and 3.6% (2.8–4.5%), respectively. Between 2012 and 2014, intentional vaccine refusal decreased slightly among parents of older children (2–6 years) but not younger children (0–1 years). The proportion of parents working to catch up on all vaccines increased while those refusing some but not all vaccines decreased. The South experienced a significant increase in estimated acceptance (90.1–94.1%) and a significant decrease in intentional ongoing refusal (5.0–2.1%). Vaccine delay increased in the Northeast (3.2–8.8%). Conclusions Nationally, acceptance and ongoing intentional delay of recommended non-influenza childhood vaccines were stable. These findings suggest that more effort is warranted to counter persistent vaccine hesitancy, particularly at the local level. Longitudinal monitoring of immunization attitudes is also warranted to evaluate temporal shifts over time and geographically.

Immunisation coverage and socioeconomic status – questioning inequity in the ‘No Jab, No Pay’ policy

“…This appears particularly true for varicella vaccine, that had the lowest coverage overall in the 24‐<27 age cohort and across all indexes. This has also been seen in the US with highest refusal rates noted for both varicella and MMR vaccines 10 …”

“…This has also been seen in the US with highest refusal rates noted for both varicella and MMR vaccines. 10 The findings also show lower immunisation coverage for all vaccines (except varicella) in the older two age cohorts in higher ranked areas when measured by the IEO. This suggests that under-vaccination in more highly skilled and educated populations may be based on vaccine concerns, rather than access issues related to financial disadvantage, as indicated by the IER.…”

Influences on Immunization Decision-Making among US Parents of Young Children

“…National childhood vaccination rates have remained consistently high over the past decade in the United States (US) (Hill et al 2015), with intentional vaccine delay estimated at 7.7–21.8% (McCauley et al 2012; Smith et al 2010) and refusal of one or more vaccines at 4.0–16% (Association of State and Territorial Health Officials 2010; Frew et al 2016; McCauley et al 2012). Yet, recent high profile outbreaks of measles (Zipprich et al 2015) and pertussis (Cherry 2012) have brought the repercussions of under-immunization to national attention, sparking sometimes polarized debates on decisional freedom and the potential public risk posed by following personal health philosophy (Omer et al 2013).…”

Simply put: Vaccination saves lives

“…A CDC report on 159 measles cases reported between January 4 and April 2, 2015, showed that 68 United States residents with measles were unvaccinated, and of these 29 (43%) cited philosophical or religious objections to vaccination (11). A 2014 national webbased poll of parents in the United States estimated that 90.8% (89.3-92.1%) reported accepting or planning to accept all recommended noninfluenza childhood vaccines, 5.6% (4.6-6.9%) reported intentionally delaying one or more, and 3.6% (2.8-4.5%) reported refusing one or more vaccines (12). A national survey of pediatricians in the United States reported that the proportion of pediatricians reporting parental vaccine refusals increased from 74.5% in 2006 to 87.0% in 2013 (13).…”