It's Complicated: The 2014–2015 U.S. Measles Outbreak and Parents’ Vaccination Beliefs, Confidence, and Intentions

Abstract

While it seems intuitive that highly visible vaccine-preventable disease outbreaks should impact perceptions of disease risk and facilitate vaccination, few empirical studies exist to confirm or dispel these beliefs. This study investigates the impact of the 2014-2015 Disneyland measles outbreak on parents' vaccination attitudes and future vaccination intentions. The analysis relies on a pair of public opinion surveys of American parents with at least one child under the age of six (N = 1,000 across each survey). Controlling for basic demographics, we found higher levels of reported confidence in the safety and efficacy of childhood vaccinations in our follow-up data collection. However, this confidence was also accompanied by elevated levels of concern toward childhood vaccines among American parents. We then examined how different subgroups in the population scored on these measures before and after the outbreak. We found that parents with high levels of interest in the topic of vaccines and a child who is not fully upto date with the recommended vaccination schedule reported more supportive attitudes toward vaccines. However, future intentions to follow the recommended vaccination schedule were not positively impacted by the outbreak. Possible explanations for these results and implications for vaccination outreach are discussed.

Public Perception of SARS-CoV-2 Vaccinations on Social Media: Questionnaire and Sentiment Analysis

“…Since their introduction, vaccinations have revolutionised health care whilst at the same time persistently facing opposition [ 4 , 5 ] from hesitant individuals who perceive them as unnecessary or dangerous [ 6 ]. ‘Anti-vaccinators’ or ‘anti-vaxxers’ may reject vaccinations in the belief that they contain toxins and cause serious adverse effects [ 7 ].…”

“…The measles, mumps, and rubella (MMR) controversy was the result of a now discredited paper linking the MMR vaccine to autism in children [ 8 , 14 ], which led to a reduction in MMR uptake after its publication in 1998 and the debate still rumbles on. Although MMR vaccination uptake has improved since 2004, according to the WHO, it is still under the 95% threshold to ensure herd immunity; and in 2017, an estimated 142,000 people died from measles unnecessarily [ 6 , 15 , 16 ], leading the WHO to declare vaccine hesitancy as an official threat to global health in 2019 [ 17 ] and highlighting the need for medical professionals to address vaccine safety concerns to encourage uptake.…”

Increases in preventable diseases due to antivaccination beliefs: Implications for schools.

“…A particularly large measles outbreak originated at the Disneyland theme park in California between 2014 and 2015, leading to 147 cases ranging across multiple states. CDC scientists believed that a traveler became infected with measles overseas and unknowingly brought the disease into the theme park (CDC, 2021a); however, most of the subsequent cases were among unvaccinated or incompletely vaccinated individuals (Cacciatore et al, 2018). An analysis of parents’ vaccination attitudes and intentions following the Disneyland outbreak showed that 40% of parents of un or undervaccinated children did not plan to have their child vaccinated as per the recommended vaccine schedule despite having favorable views of vaccination (Cacciatore et al, 2018).…”

“…CDC scientists believed that a traveler became infected with measles overseas and unknowingly brought the disease into the theme park (CDC, 2021a); however, most of the subsequent cases were among unvaccinated or incompletely vaccinated individuals (Cacciatore et al, 2018). An analysis of parents’ vaccination attitudes and intentions following the Disneyland outbreak showed that 40% of parents of un or undervaccinated children did not plan to have their child vaccinated as per the recommended vaccine schedule despite having favorable views of vaccination (Cacciatore et al, 2018). The researchers hypothesized that this group of parents may have experienced cognitive dissonance from having an unvaccinated child amidst an outbreak in which many children became ill from a vaccine-preventable disease (including some who were fully vaccinated).…”

Investigating an Issue–Attention–Action Cycle: A Case Study on the Chronology of Media Attention, Public Attention, and Actual Vaccination Behavior during the 2019 Measles Outbreak in Austria

“…Taken together, key events such as celebrities' announcements can captivate the attention of the news and subsequently increase public attention on health issues with possible important behavioral effects. As noted by Cacciatore, Nowak, and Evans (2018), while it seems intuitive that highly visible vaccinepreventable disease outbreaks should facilitate vaccination, there is a lack of empirical evidence.…”