Development of Vaccine Preferences in Parents of Newborns

Monday, October 26, 2015
Marquis Salon 14 (Marriott Marquis)
James N Yarnall, MPH, University of North Carolina School of Medicine, Chapel Hill, NC and Jacob Lohr, MD, UNC Hospitals, Chapel Hill, NC

Purpose: The recent measles outbreaks in the United States and Europe are reflections of declining vaccine coverage among vulnerable populations of children due to an increasing number of vaccine refusals and delays by parents. Much of the existing research on this issue has focused on underlying characteristics of non-vaccinators and ambivalent parents, including attitudes towards vaccines and health care, reasoning behind non-vaccination and delay, and perceived credibility of various information sources. However, few studies have looked into how or when vaccine preferences develop. In this study, we sought to explore when parental preferences for vaccines develop in relation to the pregnancy (before, during, or after); self-reported influences on vaccine decision-making were also explored as a secondary objective.

Methods: We recruited and administered a short survey to English-speaking mothers and fathers at the University of North Carolina Women's Hospital in Chapel Hill, NC, who had given birth from February to April 2015. Parents were screened for eligibility and consented three mornings a week. Chi-squared and linear regression analysis were conducted using Stata 13.1.

Results: Of the 304 eligible parents, 171 (56%) consented to taking the survey, 12 (4%) declined, and 121 (40%) were unavailable for various reasons (absent/asleep during survey implementation, breastfeeding, too tired). 72% (120) of surveyed parents reported deciding on their vaccine preferences for their newborn before conception. 66% (49) of first-time parents reported setting preferences before conception, compared to 77% (71) of parents who have had previous children (χ2 = 2.4583, p = 0.12). Fathers were more likely to report preconception preferences than mothers, but the change only approached significance (χ2 = 3.2417, p = 0.07), and the difference fell further from significance after adjusting for demographic variables (p = 0.63). Parents that reported preconception preferences were significantly more likely to plan on giving their children all recommended vaccines compared to some or no vaccines (p = 0.01), but this difference lost significance after controlling for demographic variables (p =  0.15). The most common influences for vaccine decision-making were family and friends, medical staff, and government programs like the Center for Disease Control and Prevention (CDC) and American Academy of Pediatrics (AAP).

Conclusion: Our study documents that in a significant majority of parents’ vaccine decision-making and preference formation occurs before conception. Notable influences from friends, family, and medical sources are part of the process. Plans to distribute vaccine information before conception should be considered.