Association of vaccine-related attitudes and beliefs between parents and health care providers.

OBJECTIVES: Health care providers influence parental vaccination decisions. Over 90% of parents report receiving vaccine information from their child's health care provider. The majority of parents of vaccinated children and children exempt from school immunization requirements report their child's primary provider is a good source for vaccine information. The role of health care providers in influencing parents who refuse vaccines has not been fully explored. The objective of the study was to determine the association between vaccine-related attitudes and beliefs of health care providers and parents. METHODS: We surveyed parents and primary care providers of vaccinated and unvaccinated school age children in four states in 2002-2003 and 2005. We measured key immunization beliefs including perceived risks and benefits of vaccination. Odds ratios for associations between parental and provider responses were calculated using logistic regression. RESULTS: Surveys were completed by 1367 parents (56.1% response rate) and 551 providers (84.3% response rate). Parents with high confidence in vaccine safety were more likely to have providers with similar beliefs, however viewpoints regarding disease susceptibility and severity and vaccine efficacy were not associated. Parents whose providers believed that children get more immunizations than are good for them had 4.6 higher odds of holding that same belief compared to parents whose providers did not have that belief. CONCLUSIONS: The beliefs of children's health care providers and parents, including those regarding vaccine safety, are similar. Provider beliefs may contribute to parental decisions to accept, delay or forgo vaccinations. Parents may selectively choose providers who have similar beliefs to their own.

Are Recent Medical Graduates More Skeptical of Vaccines?

Rates of delay and refusal of recommended childhood vaccines are increasing in many U.S. communities. Children's health care providers have a strong influence on parents' knowledge, attitudes, and beliefs about vaccines. Provider attitudes towards immunizations vary and affect their immunization advocacy. One factor that may contribute to this variability is their familiarity with vaccine-preventable diseases and their sequelae. The purpose of this study was to investigate the association of health care provider year of graduation with vaccines and vaccine-preventable disease beliefs. We conducted a cross sectional survey in 2005 of primary care providers identified by parents of children whose children were fully vaccinated or exempt from one or more school immunization requirements. We examined the association of provider graduation cohort (5 years) with beliefs on immunization, disease susceptibility, disease severity, vaccine safety, and vaccine efficacy. Surveys were completed by 551 providers (84.3% response rate). More recent health care provider graduates had 15% decreased odds of believing vaccines are efficacious compared to graduates from a previous 5 year period; had lower odds of believing that many commonly used childhood vaccines were safe; and 3.7% of recent graduates believed that immunizations do more harm than good. Recent health care provider graduates have a perception of the risk-benefit balance of immunization, which differs from that of their older counterparts. This change has the potential to be reflected in their immunization advocacy and affect parental attitudes.

Immunization safety in US print media, 1995-2005.

OBJECTIVE: To identify and describe vaccine safety in US newspaper articles. METHODS: Articles (1147) from 44 states and Washington, DC, between January 1, 1995, and July 15, 2005, were identified by using the search terms "immunize or vaccine" and "adverse events or safety or exemption or danger or risk or damage or injury or side effect" and were coded by using a standardized data-collection instrument. RESULTS: The mean number of vaccine-safety articles per state was 26. Six (not mutually exclusive) topics were identified: vaccine-safety concerns (46%); vaccine policy (44%); vaccines are safe (20%); immunizations are required (10%); immunizations are not required (8%); and state/school exemption (8%). Three spikes in the number of newspaper articles about vaccine-safety issues were observed: in 1999 regarding rotavirus vaccine and in 2002 and 2003 regarding smallpox vaccine. Excluding articles that referred to rotavirus and smallpox vaccines, 37% of the articles had a negative take-home message. CONCLUSION: Ongoing monitoring of news on vaccine safety may help the content and framing of vaccine-safety messages.

Prenatal immunization education the pediatric prenatal visit and routine obstetric care.

BACKGROUND: Vaccine safety concerns and lack of knowledge regarding vaccines contribute to delays in infant immunization. Prenatal vaccine education could improve risk communication and timely vaccination. This study sought to determine the proportion of obstetric practices and hospital-based prenatal education classes that provide pregnant women with infant immunization information, the willingness of obstetric practices to provide infant immunization information, and the proportion of first-time mothers who receive a pediatric prenatal visit. METHODS: A telephone survey was conducted of 100 pediatric practices and 100 obstetric practices randomly selected from the American Medical Association Physician Masterfile between January and March 2005, with analysis performed April 2005. RESULTS: Seventy-one of 100 (71%) selected obstetric practices and 85 of 100 (85%) selected pediatric practices participated. Sixteen obstetric practices (23%) reported providing pregnant women with information on routine childhood immunizations. Thirty-four of the 52 practices (65%) that did not provide such information reported willingness to do so. Ten of 51 hospitals (20%) did not provide information about routine childhood immunizations to prenatal class participants. Sixty-six of the 85 pediatric practices (78%) provided a pediatric prenatal visit. Among these, the median percentage of first-time mothers who received a visit was 30%. CONCLUSIONS: Prenatal visits are a missed opportunity for providing education about infant immunizations. Incorporating immunization education into routine obstetric prenatal care may increase maternal knowledge of infant vaccines and reduce delayed immunization.