Yarnall J Nathan, Seashore Carl, Phillipi Carrie A, Hatch Joseph E, King Beth, Hart Chayla, Lohr Jacob A
Emory University School of Medicine (JN Yarnall), Atlanta, Ga; Children's Healthcare of Atlanta (JN Yarnall), Atlanta, Ga.
University of North Carolina School of Medicine (C Seashore, JE Hatch, C Hart, and JA Lohr), Chapel Hill, NC; UNC Health - Children's (C Seashore, C Hart), Chapel Hill, NC.
Acad Pediatr. 2022 May-Jun;22(4):551-558. doi: 10.1016/j.acap.2021.10.004. Epub 2021 Nov 6.
Decreased childhood vaccination can lead to local outbreaks of vaccine-preventable disease. In a pilot study from our group, 72% of parents of newborns reported initiating their vaccine decision-making for that child prior to conception. Since a sound understanding of the timing of parental vaccine decision-making is needed to direct educational efforts, we surveyed a national cohort of first-time parents to extend our preliminary findings.
From March 2019 to March 2020, first-time parents of newborns in mother-baby units of the Better Outcomes through Research for Newborns (BORN) network completed the Vaccine Preference Development Survey (VPDS). The VPDS measures intent to vaccinate, timing of vaccine decision-making, and sources of influence. Univariate and multivariate analyses explored associations between intent to vaccinate and timing of vaccine decision-making with demographic variables.
Twenty-three sites provided surveys through site-specific nonrandom systemic sampling; 91% (1393/1524) of surveys were used in the analysis. Most parents planned to fully vaccinate (1191/1380, 86.3%) and started vaccine decision-making prior to conception (850/1378, 61.7%). Maternal age, race and ethnicity, relationship status, and education were all significantly associated with planning to fully vaccinate and preconception decision-making (P < .001). Preconception decision-making correlated strongly with intent to fully vaccinate (P < .001). Parents influenced by personal education, medical professionals, and family/friends were more likely to endorse preconception decision-making; those strongly influenced by internet/social media were less likely to allow all vaccines or start decision-making prior to conception.
Vaccine decision-making occurs preconception for most new parents. Initiating vaccine discussions during the birth hospitalization may be too late.
儿童疫苗接种率下降会导致疫苗可预防疾病的局部暴发。在我们团队的一项试点研究中，72%的新生儿父母报告称在怀孕前就开始为孩子做疫苗接种决策。由于需要深入了解父母疫苗接种决策的时机，以便指导教育工作，我们对全国范围内的初为人父母者进行了调查，以扩展我们的初步研究结果。
2019年3月至2020年3月，通过“新生儿研究改善结局”（BORN）网络母婴单元中的新生儿初为人父母者完成了疫苗偏好发展调查（VPDS）。VPDS测量疫苗接种意愿、疫苗接种决策时机以及影响因素来源。单因素和多因素分析探讨了疫苗接种意愿和疫苗接种决策时机与人口统计学变量之间的关联。
23个地点通过特定地点的非随机系统抽样提供了调查问卷；91%（1393/1524）的调查问卷用于分析。大多数父母计划为孩子全程接种疫苗（1191/1380，86.3%），并且在怀孕前就开始做疫苗接种决策（850/1378，61.7%）。母亲的年龄、种族和民族、婚姻状况以及教育程度均与计划全程接种疫苗和怀孕前决策显著相关（P <.001）。怀孕前决策与全程接种疫苗的意愿密切相关（P <.001）。受个人教育、医学专业人员以及家人/朋友影响的父母更有可能支持怀孕前决策；受互联网/社交媒体强烈影响的父母不太可能接受所有疫苗接种或在怀孕前开始做决策。
大多数初为人父母者在怀孕前就做出了疫苗接种决策。在分娩住院期间开始疫苗接种讨论可能为时已晚。
