Parental vaccine concerns, information source, and choice of alternative immunization schedules

Abstract

Alternative immunization schedules increase the time a child is unvaccinated and require greater resources from providers. Understanding what drives interest in alternative immunization schedules can potentially inform the design of effective, targeted messages that help to reduce time spent counseling and decrease requests for alternative immunization schedules. This study used the Theory of Planned Behavior to explore associations between sources of vaccine information, parental vaccine concerns, peer norms for vaccine behavior and intentions to follow an alternative immunization schedule. We performed logistic regression using medical record data from a private pediatric practice in a large northeastern city. Routine data were recorded in the EMR by the pediatrician during an initial vaccine counseling conversation with the parent(s). Parents who received vaccine information from doctors were less likely to have immunization concerns while parents who got vaccine information from friends and family or from books were more likely to report specific vaccine concerns. Our multivariate analysis shows that number of reported vaccine concerns and concerns about the utility or necessity of vaccines are strongly associated with alternative immunization intentions. We also find a direct relationship between sources of information about vaccines and alternative immunization intentions. Our results suggest that vaccine concerns and non-physician information sources play an important role in alternative immunization intentions while communication from physicians may play an important role in addressing vaccine concerns and promoting adherence to the ACIP immunization schedule.

Keywords: :

• childhood immunization schedule
• parents
• vaccination intention
• vaccine hesitancy
• information source

10.4161/hv.25959

Disclosure of Potential Conflicts of Interest

We have no conflicts of interest to disclose.

Ethics Statement

The study was approved by the Institutional Review Board of the University of Pennsylvania.

Acknowledgments

The authors thank Cecilia Davis-Hayes and Eileen Wang for manuscript assistance and Yelena Baras for assistance with data cleaning. We also thank the pediatric practice that provided the data used in our analysis.

Sources of Support

This work was supported by the Robert Wood Johnson Foundation Health and Society Scholars Program at the University of Pennsylvania and a training grant in comparative effectiveness research at the University of Pennsylvania (KM1CA156715-01).