September 20, 2016
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Motives differ between parents who refuse, delay vaccination for children

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Parents who refused to vaccinate their children were more likely to believe vaccination was unnecessary, and parents who delayed vaccines were more concerned with their child’s discomfort and immune system burden, according to recent study data.

“Decreasing parental acceptance of the benefits and safety of vaccines has resulted in increasing rates of nonmedical vaccine exemptions and of children who are underimmunized and unimmunized,” Catherine Hough-Telford, MD, a specialist in pediatric infectious disease medicine at University of Alabama Hospital, and colleagues wrote. “Historical data suggest that the reasons for these refusals and delays (also called alternative vaccine schedules) may be changing over time.”

Hough-Telford and colleagues pooled data from the national AAP Periodic Surveys from 2006 and 2013 to compare pediatrician perceptions of prevalence in vaccine refusals and delays, parental reasons for refusals or delays, and physician dismissals of parents who refuse or delay vaccines for their children. Of the AAP members who were mailed surveys in both years, responses from 629 were included in 2006 and 627 in 2013. In both surveys, pediatricians were asked whether they encountered vaccine refusals in the past 12 months and asked to estimate the number of parents in their practice who refused one, more than one or all vaccines. Vaccine delay questions were asked only on the 2013 survey.

Comparison analysis showed that pediatricians encountered an increase in vaccine refusals from 2006 (74.5%) to 2013 (87%) (P < .001). Further, physicians reported that the reason most parents decide not to vaccinate their children is because they think vaccines are unnecessary (63.4% in 2006 vs. 73.1% in 2013; P = .002). For parents who delay vaccines, pediatricians responded that parents were concerned about discomfort (75%; 95% CI, 71.3-78.7) or immune system burden (72.5%; 95% CI, 68.6-76.3) in their children.

The percentage of pediatricians who “always” dismissed parents for refusing vaccines for their children nearly doubled between surveys. It increased from 6.1% in the 2006 survey to 11.7% in 2013 (P = .004), due to largely to pediatricians’ frustrations in the lack of trust between physicians and patients’ parents.

The investigators wrote that during both survey years, educating parents resulted in pediatricians convincing only about 33% of vaccine-refusing parents to change their minds.

“More research is needed to identify effective techniques to address the concerns of vaccine-hesitant parents as identified in this report,” the researchers wrote. – by Kate Sherrer

Disclosure: The researchers report no relevant financial disclosures.