Confidence About Vaccines In The United States: Understanding Parents’ Perceptions

Kennedy, Allison; LaVail, Katherine Hart; Nowak, Glen; Basket, Michelle; Landry, Sarah

doi:10.1377/hlthaff.2011.0396

Cited by 296 publications

(206 citation statements)

References 27 publications

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“…[10][11][12][13] For instance, in a recent pan-Canadian survey, half of the parents were concerned that new vaccines are not as safe as older vaccines and one-third felt that children today receive too many vaccines, even if nine out of ten of these parents indicated their child's vaccination was up to date.…”

Section: Introductionmentioning

confidence: 99%

Vaccine hesitancy

Dubé

Laberge

Guay

et al. 2013

Human Vaccines & Immunotherapeutics

1,598

1,350

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Section: Introductionmentioning

confidence: 99%

Vaccine hesitancy

Dubé

Laberge

Guay

et al. 2013

Human Vaccines & Immunotherapeutics

1,598

1,350

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“…[1][2][3] As public confidence in vaccines erodes, [4][5][6][7] parents hesitate about vaccine decisions, vaccination rates may decrease, and outbreaks of vaccinepreventable disease may be more likely. [8][9][10][11] Physicians are highly influential on parental beliefs and attitudes about childhood vaccinations, 7,12-14 yet many feel unprepared to address questions from vaccine-hesitant parents.…”

mentioning

confidence: 99%

Physician Communication Training and Parental Vaccine Hesitancy: A Randomized Trial

et al. 2015

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BACKGROUND AND OBJECTIVES: Physicians have a major influence on parental vaccine decisions. We tested a physician-targeted communication intervention designed to (1) reduce vaccine hesitancy in mothers of infants seen by trained physicians and (2) increase physician confidence in communicating about vaccines. METHODS:We conducted a community-based, clinic-level, 2-arm cluster randomized trial in Washington State. Intervention clinics received physician-targeted communications training. We enrolled mothers of healthy newborns from these clinics at the hospital of birth. Mothers and physicians were surveyed at baseline and 6 months. The primary outcome was maternal vaccine hesitancy measured by Parental Attitudes on Childhood Vaccines score; secondary outcome was physician self-efficacy in communicating with parents by using 3 vaccine communication domains. RESULTS:We enrolled 56 clinics and 347 mothers. We conducted intervention trainings at 30 clinics, reaching 67% of eligible physicians; 26 clinics were randomized to the control group. Maternal vaccine hesitancy at baseline and follow-up changed from 9.8% to 7.5% in the intervention group and 12.6% to 8.0% in the control group. At baseline, groups were similar on all variables except maternal race and ethnicity. The intervention had no detectable effect on maternal vaccine hesitancy (adjusted odds ratio 1.22, 95% confidence interval 0.47-2.68). At follow-up, physician self-efficacy in communicating with parents was not significantly different between intervention and control groups.CONCLUSIONS: This physician-targeted communication intervention did not reduce maternal vaccine hesitancy or improve physician self-efficacy. Research is needed to identify physician communication strategies effective at reducing parental vaccine hesitancy in the primary care setting.

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“…These and other related programs that allow for providerparent interaction while providing vaccine education hold the promise of improving community confidence in immunizations. 18 Ninety-three percent of parents in our study stated that they believed their children to be vaccine-complete at the time of enrollment; however, only 39% stated that they had received a 2011-2012 influenza vaccine. This observation illustrates that many parents do not consider annual influenza vaccine a routine recommendation.…”

Section: Discussionmentioning

confidence: 66%

“…[18][19][20][21][22][23] Misperceptions regarding influenza infection and vaccine safety reduce public confidence in vaccines and contribute to poor vaccine uptake. [23][24][25] Humiston and colleagues 19 found that participants who believed that influenza infection was serious and that the vaccine did not cause disease had greater intent to vaccinate their children than those who did not, further supporting the importance of parental education in childhood immunization programs.…”

Section: Discussionmentioning

confidence: 99%

Community-Centered Education Improves Vaccination Rates in Children From Low-Income Households

et al. 2013

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WHAT'S KNOWN ON THIS SUBJECT: Obstacles to vaccine delivery, including poverty, reduced access to medical care, and incomplete understanding of vaccine safety and importance, result in suboptimal coverage rates in some populations, allowing for disease outbreaks. Multicomponent interventions are successful in increasing immunization coverage rates. WHAT THIS STUDY ADDS:We show that collaboration with local resources, including the county health department and a large community-based organization, effectively increases immunization coverage rates in low-income, resource-poor children.abstract OBJECTIVE: We partnered with the Salvation Army to educate resourcepoor families regarding childhood immunizations in an effort to improve vaccine coverage rates. METHODS:Eligibility for enrollment included children of families presenting at registration for our Salvation Army holiday gift program, available to families with an annual income ,150% of federal poverty guidelines. Parents completed a questionnaire, were provided each child' s vaccination status as documented in the New York State Immunization Information System, and interacted with the study team to address immunization-related concerns. Missed vaccines were identified and parents were directed to their child' s medical home for necessary immunizations. Vaccine coverage was ascertained via the New York State Immunization Information System every 6 to 8 weeks with telephone follow-up for children who remained delayed. The McNemar test and standard 2-proportion comparison were used to determine confidence intervals when analyzing matched or independent data, respectively. RESULTS:A total of 1531 children were enrolled; 416 (28%) of the 1477 children with accurate immunization records were vaccine complete. When we excluded influenza vaccine, 1034 (70%) of children had received all other recommended vaccines. Nine months later, vaccine completion rates increased from 28% to 45%, largely because of improvements in influenza vaccination rates, which increased by 17% (confidence interval [CI] 15.5-19.5), a significant improvement over county (8%, 95% CI 7.4-8.1) and statewide (5%, 95% CI 4.7-4.8) rates during the same period. CONCLUSIONS:Immunization rates in poor children are suboptimal. Partnering with community-based organizations to address parental concerns, provide education, and perform follow-up was effective in improving immunization rates, particularly for influenza vaccine. Pediatrics 2013;132:319-325

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Confidence About Vaccines In The United States: Understanding Parents’ Perceptions

Cited by 296 publications

References 27 publications

Vaccine hesitancy

Vaccine hesitancy

Physician Communication Training and Parental Vaccine Hesitancy: A Randomized Trial

Community-Centered Education Improves Vaccination Rates in Children From Low-Income Households

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