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. 2017 Nov 21;17(1):194.
doi: 10.1186/s12887-017-0944-3.

"Lay epidemiology": an important factor in Danish parents' decision of whether to allow their child to receive a BCG vaccination. A qualitative exploration of parental perspective

Gitte Thybo Pihl  1   2 , Helle Johannessen  3 , Jette Ammentorp  3   4 , Jane Schmidt Jensen  4 , Poul-Erik Kofoed  5   3
Affiliations

"Lay epidemiology": an important factor in Danish parents' decision of whether to allow their child to receive a BCG vaccination. A qualitative exploration of parental perspective

Gitte Thybo Pihl et al. BMC Pediatr. .

Abstract

Background: Vaccination is used worldwide to prevent infectious diseases. However, vaccination programmes in western countries face challenges in sustaining high coverage rates. The aim of this study was to explore how parents in Denmark make a decision about whether to allow their child to receive a Bacille Calmette Guerin vaccine at birth for the purpose of achieving non-specific effects on the immune system.

Methods: A total of five focus groups were conducted with expectant mothers and fathers. Written information about the vaccine and information about the hypothesis of non-specific effects of the vaccine were delivered in order to discuss considerations and determinants of parents' decisions.

Results: Heritable factors and the possibility of stimulating the immune system of the child to achieve less atopic diseases and fewer infections were identified as arguments in favour of receiving the BCG vaccine. Arguments against receiving BCG mainly focused on concerns about its described and non-described side effects. Both arguments for and arguments against the vaccine were seen as parents attempt to make an individual risk evaluation for their child. Attitudes and beliefs in the local network were identified as important for parents' decisions.

Discussion: It is discussed how "lay epidemiology" characterizes parents' risk evaluation as an individual addition to the population-based risk declaration. It is furthermore discussed how health professionals should engage with both the empirical element and the value element of "Lay epidemiology".

Conclusion: "Lay epidemiology" forms the basis for the parental decision of whether to allow their child to receive a BCG vaccination. Attitudes and beliefs about the causes and distribution of illnesses in the family or local network influence parents' risk evaluations. It would be ideal for parents if health professionals focused their communication about the BCG vaccine on individual risk evaluations.

Keywords: Decision making; Heterologous immunity.; Lay epidemiology; Patient-provider communication; Risk evaluation; Vaccine safety concerns; Values.

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Conflict of interest statement

Ethics approval and consent to participate

The study was conducted according to the principles expressed in the Declaration of Helsinki. Informed consent was provided by all participants. All personal identifiers have been removed or disguised so that the persons described here are not identifiable and cannot be identified through the details of the article. According to Danish law, ethical approval is not required for conducting interviews as long as data is non-sensitive and used fully anonymous.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interest.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Description of the adverse reactions presented to the participants in the focus groups
Fig. 2
Fig. 2
Background information presented to the participants in the focus groups
See this image and copyright information in PMC

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