An Ounce of Prevention: Identifying Cues to (In)Action for Maternal Vaccine Refusal.

Recent increases in childhood vaccine exemption rates are a source of concern within the public health community. Drawing from the health belief model and in-depth interviews with 50 mothers ( n = 50) who refused one or more vaccine, the aim of this study was to identify the specific reasons and the broader decision context(s) that underscored participants' vaccine refusal. Results indicate that the vast majority of participants supported vaccination until a particular cue motivated them to consider otherwise, and qualitative analysis identified three main categories into which these cues fell: perceived adverse reactions, endorsements from health care professionals, and perceived contradiction among expert-endorsed messages. These categories point to the central role of health communication in motivating vaccine refusal. Better understanding these cues can inform vaccine communication scholarship and practice, and also lend theoretical insight into the intertextual nature of controversial health messages and decisions.