Health Information Sources, Perceived Vaccination Benefits, and Maintenance of Childhood Vaccination Schedules

ABSTRACT

Parental concerns over the safety or necessity of childhood vaccination have increased over the past decades. At the same time, there has been a proliferation of vaccine-related information available through a range of health information sources. This study investigates the associations between evaluations of health information sources, parental perceptions of childhood vaccination benefits, and the maintenance of vaccination schedules for their children. Specifically, this study aims to (a) incorporate social media into the battery of health information sources and (b) differentiate households with a childhood autism diagnosis and those without, given unsubstantiated but persistent concerns about vaccine safety and autism. Analyzing a sample of U.S. households, a total of 4,174 parents who have at least one child under the age of 18 were analyzed, including 138 of parents of households with a childhood autism diagnosis. Results show that the more the parents value interpersonal communication and magazines as sources of health information, the more they perceive vaccination benefits, and the more the value they put on television, the better they keep vaccination schedules up-to-date for their children. On the other hand, social media are negatively associated with their perceptions of vaccination benefits. Although parents of children diagnosed with autism are less likely to perceive vaccination benefits, no interaction effects with evaluations of health information sources are found on parental perceptions of vaccination benefits or maintenance of schedules.

Notes

¹ For instance, during the 2015–2016 school year, median kindergarten vaccination coverage was 94.6% for 2 doses of measles, mumps, and rubella vaccine (MMR) and 94.2% for local requirements for diphtheria, tetanus, and acellular pertussis vaccine among 49 states and the District of Columbia (DC) (see Seither et al., 2016).

² According to 2009–2010 through 2016–2017 school year, vaccination exemptions trend report (Centers for Disease Control and Prevention, 2017), kindergarten nonmedical exemption rates of Oregon, for instance, has increased from 5.2% (2009–2010), to 5.8% (2014–2015), to 6.5% (2016–2017).

³ Although we planned to conduct SEM with two different groups (parents of children diagnosed with autism and those without), due to the relatively small sample size for the group of parents of children diagnosed with autism (N = 138), we examined interaction effects using hierarchical regression analysis. Since we addressed missing data and non-normality issue with the SEM, and this model addressed our research questions more precisely, we interpreted the main effects using the SEM.

⁴ All the 50 states and the District of Columbia required 2 doses of a measles-containing vaccine, with MMR as the only measles-containing vaccine available in the United States. For local DTaP vaccine requirements, Nebraska required 3 doses, 4 states (Illinois, Pennsylvania, Virginia, and Wisconsin) required 4 doses, Pennsylvania did not require pertussis, and all other states required 5 doses unless the fourth dose was administered on or after the fourth birthday. Kentucky required 5 doses of DTaP by age 5, but reported 4-dose coverage for kindergartners. For varicella vaccine, eight states required 1 dose and 42 states and DC required 2 doses. Alabama, Florida, Georgia, Iowa, Mississippi, New Hampshire, and New Jersey considered kindergartners up-to-date only if they had received all doses of all vaccines required for school entry (Seither et al., 2016).