Changes in childhood immunization decisions in the United States: Results from 2012 & 2014 National Parental Surveys

Abstract

Objective: Understanding the current status of parents' vaccine decision making is crucial to inform public policy. We sought to assess changes in vaccine decisions among parents of young children.

Methods: We conducted a web-based national poll of parents of children <7years in 2012 and 2014. Participants reported vaccine decisions for their youngest child. We calculated survey-weighted population estimates of overall immunizations decisions, and delay/refusal rates for specific vaccines.

Results: In 2012, 89.2% (95% CI, 87.3-90.8%) reported accepting or planning to accept all recommended non-influenza childhood vaccines, 5.5% (4.5-6.6%) reported intentionally delaying one or more, and 5.4% (4.1-6.9%) reported refusing one or more vaccines. In 2014, the acceptance, delay, and refusal rates were 90.8% (89.3-92.1%), 5.6% (4.6-6.9%), and 3.6% (2.8-4.5%), respectively. Between 2012 and 2014, intentional vaccine refusal decreased slightly among parents of older children (2-6years) but not younger children (0-1years). The proportion of parents working to catch up on all vaccines increased while those refusing some but not all vaccines decreased. The South experienced a significant increase in estimated acceptance (90.1-94.1%) and a significant decrease in intentional ongoing refusal (5.0-2.1%). Vaccine delay increased in the Northeast (3.2-8.8%).

Conclusions: Nationally, acceptance and ongoing intentional delay of recommended non-influenza childhood vaccines were stable. These findings suggest that more effort is warranted to counter persistent vaccine hesitancy, particularly at the local level. Longitudinal monitoring of immunization attitudes is also warranted to evaluate temporal shifts over time and geographically.

Keywords: Immunization coverage; Vaccine acceptability; Vaccine delay; Vaccine hesitancy; Vaccine refusal.

Fig. 1

Population estimates and changes in choices for recommended non-influenza vaccinations of youngest child by US census region. *Proportion in this region significantly changed from survey year 2012 to 2014 (p < 0.05). **Proportion in this region significantly changed from survey year 2012 to 2014 (p < 0.01).

Fig. 2

Immunization decisions regarding specific childhood vaccinations. CI = Confidence Interval. Reported Delay = Delayed, but did not refuse the indicated vaccine. Does not include participants who delayed the vaccine, but were unsure of refusal. Unsure of Delay = Unsure if delayed, and did not refuse, the specified vaccine. Includes those who delayed but were unsure of refusal. Reported Refusal = Refused the indicated vaccine. Unsure of Refusal = Unsure if refused the indicated vaccine.