Parental doubts over childhood vaccines common

By Anthony J. Brown, MD

NEW YORK (Reuters Health) - Roughly one in four parents express doubts about the risks and benefits of various vaccines for their children and, in many cases, they delay or forgo vaccination, new research shows. However, the findings also suggest that physicians can play an important role in encouraging vaccination.

This is the first nationally representative study of parents' behavior regarding vaccinating their children. The parents were classified into one of three groups: those who were not sure if vaccination was the best thing to do ('unsure'); parents who delayed the vaccination of their child ('delayed'); or those who decided not to have their child vaccinated ('refused'), lead author Dr. Deborah A. Gust told Reuters health.

"The biggest finding," according to Gust, a researcher with the Centers for Disease Control and Prevention in Atlanta, "is that the largest proportion of parents who changed their minds about delaying or not getting an immunization for their child listed 'information or assurances from health care provider' as the main reason. Previous studies have also indicated the importance of physician discussion with parents regarding vaccines."

The results, reported in the medical journal Pediatrics, are based on an analysis of 3,924 interviews that were conducted as part of the National Immunization Survey (2003-2004). The survey response rates in 2003 and 2004 were 57.9 percent and 65.0 percent, respectively.

Overall, 28 percent of parents fit into at least one of the three study groups -- unsure, delayed, or refused. Concern about vaccine safety was identified as a predictor in all three groups.

Chickenpox (varicella) vaccine was the principal vaccine prompting concerns in the unsure and refused groups. In the delayed group, by contrast, no specific vaccine was cited as causing concern and most delays were related to an underlying medical condition in the child.

"To avoid future outbreaks of vaccine preventable diseases, it will be key for healthcare providers to improve education and communication with parents concerned about immunizations," Gust emphasized.

"Today, we live in a world already benefiting from existing vaccines and there is the promise of more to come. The challenge we face is to make sure that the promise is not lost because we did not present the benefits and risks of vaccines in a way acceptable to the public."

SOURCE: Pediatrics, October 2008.