Perceptions of Vaccine Efficacy, Illness, And Health Among Inner-City Parents

Abstract

A resurgence of measles in the past decade has focused attention on the limitations of current immunization programs, particularly for inner-city, low-income populations. As part of a larger study of immunization rates, we discussed perceptions of disease severity and vaccine efficacy, as well as the prioritization of the tasks of parenthood, with 40 parents of infants living in inner-city Baltimore to discover their beliefs about immunization. Vaccines were considered only partly successful; susceptibility to chickenpox after vaccination was repeatedly cited as evidence of vaccine failure. Fever was seen as a primary indicator of illness; thus, vaccines were believed to cause, rather than prevent, illness. Immunization was not considered a high-priority parental responsibility. These findings suggest future interventions be aimed at changing parental perceptions of vaccines as ineffective and of fever after immunization as an indicator of illness. Finally, immunizations should be made easily available, even during clinic visits for a child's illness.

Systematic review of qualitative studies exploring parental beliefs and attitudes toward childhood vaccination identifies common barriers to vaccination

“…From these 54 studies, 15 met the inclusion criteria and were included in the systematic review. Of these 15 studies, 8 used semistructured interviews (a total of 201 participants) [17][18][19][20][21][22][23][24], 5 used focus groups [23,[25][26][27][28] (total n 5 236), and 2 used both interviews and focus groups [29,30] (total n 5 107). Studies using both interviews and focus groups were analyzed according to their primary reported methods (which in these two instances was the semistructured interview).…”

“…The median study size for semistructured interview studies was 22; for focus group studies it was 48. The studies were conducted in five different countries: six were from the United States [22,23,[25][26][27]30], three from the United Kingdom [20,28,31], two from Canada [21,24], two from Australia [17,19], one from Ireland [18], and one from New Zealand [27,29]. Eight studies examined a variety of attitudes toward vaccines, including barriers [18,[21][22][23]25,[29][30][31], and seven studies sought only to examine barriers to obtaining vaccination [17,19,20,24,[26][27][28].…”

Systematically reviewing qualitative studies complements survey design: An exploratory study of barriers to paediatric immunisations

“…Of the 15 qualitative studies included in our systematic review, 8 studies used semistructured interviews (a total of 201 participants) [9][10][11][12][13][14][15][16], 5 used focus groups [15,[17][18][19][20] (total n ϭ 236), and 2 used both interviews and focus groups [21,22] (total n ϭ 107). The data represents 544 participants in total.…”

“…We also examined the extent to which surveys took into account the results of previously published qualitative studies. Six qualitative studies were published in 1997 or earlier [17][18][19][20][21][22], and 10 surveys were published in 1999 or later [24,27,28,31,32,35,39,[45][46][47]. Of the 12 issues raised in three or fewer of these qualitative studies, each of the 12 were represented in five or fewer of the surveys.…”

Impact of the Change to Inactivated Poliovirus Vaccine on the Immunization Status of Young Children in the United States: A Study From Pediatric Research in Office Settings and the National Medical Association

“…Concerns about increasing number of injections and changes in immunization practices might be heightened in parents of underserved children in whom health beliefs regarding vaccines are less positive than among less disadvantaged families. 16 However, despite multiple analyses specifically designed to elucidate any negative effects, the results of our study strongly indicate that the use of IPV has had no significant impact on the immunization status of young children in the United States. Patients who received an initial dose of IPV were at least as likely to be fully immunized at 8 and 12 months of age as those immunized with OPV; similarly, the timeliness of vaccination against polio was equivalent in IPV and OPV recipients.…”