Chung Yunmi, Schamel Jay, Fisher Allison, Frew Paula M
Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, USA.
Oak Ridge Institue for Science and Education (ORISE), Oak Ridge, USA.
Matern Child Health J. 2017 Dec;21(12):2178-2187. doi: 10.1007/s10995-017-2336-6.
Objectives This study assessed influences on vaccination decisions among parents of young children and examined common vaccination information and advice sources. Methods Using panel samples of parents of children under 7 years, web-based surveys were conducted in 2012 (n = 2603) and 2014 (n = 2518). A vaccine decision-making typology (non-hesitant acceptors, hesitant acceptors, delayers, and refusers) was established and weighted population estimates of potential factors influencing parental vaccination decision (e.g., provider influence, source of information and advice) were computed by year and decision type. Results Delayers and refusers were more likely than acceptors to know someone whose child experienced a severe reaction to a vaccine or delayed/refused vaccine(s). High proportions of delayers (2012: 33.4%, 2014: 33.9%) and refusers (2012: 49.6%, 2014: 58.6%) reported selecting their healthcare provider based on whether the provider would allow them to delay/refuse vaccines. Providers were the most frequently reported trusted vaccine information source among all parents, though more often by acceptors than refusers (2012, 2014: p < 0.01). We found differing patterns of provider advice-seeking and internet as a reliable vaccine information source by group. Among those who had considered delay/refusal, trust in their healthcare provider's advice was the most common reason cited for their decision reversal. Conclusions for Practice Provider trust and communication along with varying degrees of personal-network influences likely contribute to immunization decisions of parents. Vaccine hesitant parents often seek providers amenable to accommodating their vaccine beliefs. Providers may benefit from vaccine communication training as their recommendations may influence hesitant parents to immunize their children.
目的 本研究评估了对幼儿家长疫苗接种决策的影响，并调查了常见的疫苗接种信息和建议来源。方法 利用7岁以下儿童家长的面板样本，于2012年（n = 2603）和2014年（n = 2518）进行了基于网络的调查。建立了疫苗决策类型（非犹豫接受者、犹豫接受者、延迟者和拒绝者），并按年份和决策类型计算了影响家长疫苗接种决策的潜在因素（如提供者影响、信息和建议来源）的加权人口估计数。结果 与接受者相比，延迟者和拒绝者更有可能认识其孩子对疫苗有严重反应或延迟/拒绝接种疫苗的人。高比例的延迟者（2012年：33.4%，2014年：33.9%）和拒绝者（2012年：49.6%，2014年：58.6%）报告称，他们选择医疗服务提供者是基于该提供者是否允许他们延迟/拒绝接种疫苗。在所有家长中，提供者是最常被报告的可信赖的疫苗信息来源，不过接受者比拒绝者更常提及（2012年、2014年：p < 0.01）。我们发现不同群体在向提供者寻求建议以及将互联网作为可靠疫苗信息来源方面存在不同模式。在那些考虑过延迟/拒绝接种的人中，信任医疗服务提供者的建议是他们改变决定最常提到的原因。实践结论 提供者的信任和沟通以及不同程度的个人网络影响可能会影响家长的免疫决策。对疫苗接种持犹豫态度的家长通常会寻找愿意接受其疫苗观念的提供者。提供者可能会从疫苗沟通培训中受益，因为他们的建议可能会影响犹豫不决的家长为孩子接种疫苗。
