Public healthWhen parents hesitate about vaccines, what should health-care providers say?
In recent years, the United States has witnessed multiple outbreaks of vaccine-preventable illnesses, including pertussis (whooping cough) and measles. In the same time frame, vaccine refusal rates have gone up, and an increasing number of parents are requesting modified vaccine schedules that differ from the one recommended by the American Academy of Pediatrics (AAP). Although research overwhelmingly supports the safety and effectiveness of vaccines and indicates that the risk of negative side effects from childhood vaccines is extremely small, many parents still have concerns about vaccine safety. More research is needed to determine which interventions and ways of communicating information about vaccination are most effective at reducing parents’ vaccine hesitancy and refusal. What is clear from existing research is that respectful, tailored communications and recommendations to immunize coming directly from the health-care provider are associated with increased vaccination uptake.
In recent years, the United States has witnessed multiple outbreaks of vaccine-preventable illnesses, including pertussis (whooping cough) and measles. In the same time frame, vaccine refusal rates have gone up, and an increasing number of parents are requesting modified vaccine schedules that differ from the one recommended by the American Academy of Pediatrics (AAP).
The majority of parents do have their children vaccinated on schedule. It’s a small number of parents who refuse all vaccinations for their children. A slightly larger minority want their children to receive some but not all vaccines or want a different vaccination schedule.
Why do these groups disregard AAP recommendations about vaccination? A 2011 study suggests it has a lot to do with fear of vaccines’ negative side effects. Some parents worry about the “chemical composition” of vaccines or multiple vaccines being given at once. Some don’t believe vaccines are effective. Others feel the illnesses some vaccines protect against, like influenza or varicella (chickenpox), aren’t that serious. Importantly, though not the focus of this article, the AAP Committee on Bioethics notes that some parents might refuse vaccines due to cost issues or barriers to accessing appropriate health services.
Although research overwhelmingly supports the safety and effectiveness of vaccines and indicates that the risk of negative side effects from childhood vaccines is extremely small, many parents still have concerns about vaccine safety.
Parents today have access to incredible amounts of information via the Internet, which has been shown to significantly affect parents’ vaccine attitudes. Within this wealth of information about immunization, it can be challenging for parents to separate what’s reliable from what’s not. And, we tend to seek out, pay more attention to, and recall information that we suspect might be true. This is called biased assimilation. So a parent who believes vaccines are dangerous might preferentially register information supporting that view.
The continuum of vaccine attitudes
Vaccine attitudes fall on a continuum. At one end, there are parents who are completely in favor of vaccines, and at the other end are parents who oppose vaccines. In between there is a broad and complex spectrum of parents who are vaccine-hesitant or vaccine-uncertain. The common thread among all parents – no matter their vaccination choices – is that they’re trying to do what they feel is best for their children.
