Skip to main content
Top
Published in: BMC Public Health 1/2019

Open Access 01-12-2019 | Vaccination | Research article

Maternal perceptions of childhood vaccination: explanations of reasons for and against vaccination

Authors: Deborah A. McNeil, Melissa Mueller, Shannon MacDonald, Sheila McDonald, Vineet Saini, James D. Kellner, Suzanne Tough

Published in: BMC Public Health | Issue 1/2019

Login to get access

Abstract

Background

Understanding reasons for and against vaccination from the parental perspective is critical for designing vaccination campaigns and informing other interventions to increase vaccination uptake in Canada. The objective of this study was to understand maternal vaccination decision making for children.

Methods

Mothers participating in a longitudinal community-based pregnancy cohort, the All Our Babies study in Calgary, Alberta, completed open-ended survey questions providing explanations for the vaccination status of their child by 24 months postpartum. Qualitative responses were linked to administrative vaccination records to examine survey responses and recorded child vaccination status.

Results

There were 1560 open-ended responses available; 89% (n = 1391) provided explanations for vaccinating their children, 5% (n = 79) provided explanations for not vaccinating/delaying, and 6% (n = 90) provided explanations for both. Themes were similar for those vaccinating and not vaccinating/delaying; however, interpretations were different. Two broad themes were identified: Sources of influence and Deliberative Processes. Sources of influence on decision making included personal, family, and external experiences. Deliberative Processes included risk, research, effectiveness, and balancing risks/benefits. Under Deliberative Processes, responsibility was a category for those vaccinating; while choice, instrumental/practical, and health issues were categories for those not vaccinating/delaying. Mothers’ levels of conviction and motivation provided a Context for understanding their decision making perspectives.

Conclusions

Vaccination decision making is complex and impacted by many factors that are similar but contribute to different decisions depending on mothers’ perspectives. The results of this study indicate the need to examine new intervention approaches to increase uptake that recognize and address feelings of pressure and parental commitment to choice.
Literature
2.
go back to reference Omer SB, Salmon DA, Orenstein WA, MP DH, Halsey N. Vaccine Refusal, Mandatory Immunization, and the Risks of Vaccine-Preventable Diseases. N Engl J Med. 2009;360(19):1981–8.CrossRef Omer SB, Salmon DA, Orenstein WA, MP DH, Halsey N. Vaccine Refusal, Mandatory Immunization, and the Risks of Vaccine-Preventable Diseases. N Engl J Med. 2009;360(19):1981–8.CrossRef
3.
go back to reference Dubé E, Gagnon D, Ouakki M, Bettinger JA, Guay M, Halperin S, Wilson K, Graham J, Witteman HO, MacDonald S, Fisher W, Monnais L, Tran D, Gagneur A, Guichon J, Saini V, Heffernan JM, Meyer S, Driedger M, Greenberg J, MacDougall H. Understanding Vaccine Hesitancy in Canada: Results of a Consultation Study by the Canadian Immunization Research Network. PLoS One. 2016:11(6). Dubé E, Gagnon D, Ouakki M, Bettinger JA, Guay M, Halperin S, Wilson K, Graham J, Witteman HO, MacDonald S, Fisher W, Monnais L, Tran D, Gagneur A, Guichon J, Saini V, Heffernan JM, Meyer S, Driedger M, Greenberg J, MacDougall H. Understanding Vaccine Hesitancy in Canada: Results of a Consultation Study by the Canadian Immunization Research Network. PLoS One. 2016:11(6).
4.
go back to reference Dubé E, Laberge C, Guay M, Bramadat P, Roy R, Bettinger JA. Vaccine hesitancy. Hum Vaccin Immunother. 2013;9(8):1763–73.CrossRef Dubé E, Laberge C, Guay M, Bramadat P, Roy R, Bettinger JA. Vaccine hesitancy. Hum Vaccin Immunother. 2013;9(8):1763–73.CrossRef
7.
go back to reference McDonald SW, Lyon AW, Benzies KM, McNeil DA, Lye SJ, Dolan SM, Pennell CE, Bocking AD, Tough SC. The all our babies pregnancy cohort: design, methods, and participant characteristics. BMC Pregnancy Childbirth. 2013;13(1):1.CrossRef McDonald SW, Lyon AW, Benzies KM, McNeil DA, Lye SJ, Dolan SM, Pennell CE, Bocking AD, Tough SC. The all our babies pregnancy cohort: design, methods, and participant characteristics. BMC Pregnancy Childbirth. 2013;13(1):1.CrossRef
8.
go back to reference Miles MB, Huberman AM. Qualitative data analysis: an expanded sourcebook. 2nd ed. Thousand Oaks: Sage; 1994. Miles MB, Huberman AM. Qualitative data analysis: an expanded sourcebook. 2nd ed. Thousand Oaks: Sage; 1994.
9.
go back to reference Tufford L, Newman P. Bracketing in Qualitative Research. Qual Soc Work. 2012;11(1):80–96.CrossRef Tufford L, Newman P. Bracketing in Qualitative Research. Qual Soc Work. 2012;11(1):80–96.CrossRef
10.
go back to reference Chaudry A, Henly J, Meyers M. Conceptual Frameworks for Child Care Decision-Making. White Paper. Administration for Children & Families 2010. Chaudry A, Henly J, Meyers M. Conceptual Frameworks for Child Care Decision-Making. White Paper. Administration for Children & Families 2010.
11.
go back to reference Damnjanović K, Graeber J, Ilic S, Lam WY, Lep Ž, Morales S, et al. Parental decision-making on childhood vaccination. Front Psychol. 2018;9:735.CrossRef Damnjanović K, Graeber J, Ilic S, Lam WY, Lep Ž, Morales S, et al. Parental decision-making on childhood vaccination. Front Psychol. 2018;9:735.CrossRef
12.
go back to reference Leask J, Kinnersley P, Jackson C, Cheater F, Bedford H, Rowles G. Communicating with parents about vaccination: a framework for health professionals. BMC Pediatr. 2012;12:154.CrossRef Leask J, Kinnersley P, Jackson C, Cheater F, Bedford H, Rowles G. Communicating with parents about vaccination: a framework for health professionals. BMC Pediatr. 2012;12:154.CrossRef
13.
go back to reference Gowda C, Dempsey AF. The rise (and fall?) of parental vaccine hesitancy. Human vaccines & immunotherapeutics. 2013;9(8):1755–62.CrossRef Gowda C, Dempsey AF. The rise (and fall?) of parental vaccine hesitancy. Human vaccines & immunotherapeutics. 2013;9(8):1755–62.CrossRef
14.
go back to reference Gust D, Brown C, Sheedy K, Hibbs B, Weaver D, Nowak G. Immunization attitudes and beliefs among parents: beyond a dichotomous perspective. Am J Health Behav. 2005 Jan;29(1):81–92.CrossRef Gust D, Brown C, Sheedy K, Hibbs B, Weaver D, Nowak G. Immunization attitudes and beliefs among parents: beyond a dichotomous perspective. Am J Health Behav. 2005 Jan;29(1):81–92.CrossRef
15.
go back to reference Keane MT, Walter MV, Patel BI, Moorthy S, Stevens RB, Bradley KM, et al. Confidence in vaccination: a parent model. Vaccine. 2005;23(19):2486–93.CrossRef Keane MT, Walter MV, Patel BI, Moorthy S, Stevens RB, Bradley KM, et al. Confidence in vaccination: a parent model. Vaccine. 2005;23(19):2486–93.CrossRef
16.
go back to reference Tickner S, Leman PJ, Woodcock A. Parents’ views about pre-school immunization: an interview study in southern England. Child Care Health Dev. 2009;36(2):190–7.CrossRef Tickner S, Leman PJ, Woodcock A. Parents’ views about pre-school immunization: an interview study in southern England. Child Care Health Dev. 2009;36(2):190–7.CrossRef
17.
go back to reference Wilson K, Barakat M, Vohra S, Ritvo P, Boon H. Parental views on pediatric vaccination: the impact of competing advocacy coalitions. Public Underst Sci. 2008;17(2):231–43.CrossRef Wilson K, Barakat M, Vohra S, Ritvo P, Boon H. Parental views on pediatric vaccination: the impact of competing advocacy coalitions. Public Underst Sci. 2008;17(2):231–43.CrossRef
18.
go back to reference Attwell K, Smith DT. Parenting as politics: social identity theory and vaccine hesitant communities. Int J Health Gov. 2017;22(3):183–98.CrossRef Attwell K, Smith DT. Parenting as politics: social identity theory and vaccine hesitant communities. Int J Health Gov. 2017;22(3):183–98.CrossRef
19.
go back to reference Skea ZC, Entwistle VA, Watt I, Russell E. ‘Avoiding harm to others’ considerations in relation to parental measles, mumps and rubella (MMR) vaccination discussions–an analysis of an online chat forum. Soc Sci Med. 2008;67(9):1382–90.CrossRef Skea ZC, Entwistle VA, Watt I, Russell E. ‘Avoiding harm to others’ considerations in relation to parental measles, mumps and rubella (MMR) vaccination discussions–an analysis of an online chat forum. Soc Sci Med. 2008;67(9):1382–90.CrossRef
20.
go back to reference Austin H, Campion-Smith C, Thomas S, Ward W. Parents’ difficulties with decisions about childhood immunization. Community Pract. 2008;81:32+.PubMed Austin H, Campion-Smith C, Thomas S, Ward W. Parents’ difficulties with decisions about childhood immunization. Community Pract. 2008;81:32+.PubMed
21.
go back to reference Busse JW, Walji R, Wilson K. Parents’ experiences discussing pediatric vaccination with healthcare providers: A survey of canadian naturopathic patients. PLoS One. 2011;6(8):e22737.CrossRef Busse JW, Walji R, Wilson K. Parents’ experiences discussing pediatric vaccination with healthcare providers: A survey of canadian naturopathic patients. PLoS One. 2011;6(8):e22737.CrossRef
22.
go back to reference Harmsen IA, Mollema L, Ruiter RAC, Paulussen TGW, de Melker HE, Kok G. Why parents refuse childhood vaccination: a qualitative study using online focus groups. BMC Public Health. 2013;13:1183.CrossRef Harmsen IA, Mollema L, Ruiter RAC, Paulussen TGW, de Melker HE, Kok G. Why parents refuse childhood vaccination: a qualitative study using online focus groups. BMC Public Health. 2013;13:1183.CrossRef
23.
go back to reference Sturm LA, Mays RM, Zimet GD. Parental beliefs and decision making about child and adolescent immunization: from polio to sexually transmitted infections. J Dev Behav Pediatr. 2005;26(6):441–52.CrossRef Sturm LA, Mays RM, Zimet GD. Parental beliefs and decision making about child and adolescent immunization: from polio to sexually transmitted infections. J Dev Behav Pediatr. 2005;26(6):441–52.CrossRef
24.
go back to reference Luthy KE, Beckstrand RL, CJH M. Common Perceptions of Parents Requesting Personal Exemption From Vaccination. J School Nurs. 2013;29(2):95–103.CrossRef Luthy KE, Beckstrand RL, CJH M. Common Perceptions of Parents Requesting Personal Exemption From Vaccination. J School Nurs. 2013;29(2):95–103.CrossRef
25.
go back to reference Mills E, Jadad AR, Ross C, Wilson K. Systematic review of qualitative studies exploring parental beliefs and attitudes toward childhood vaccination identifies common barriers to vaccination. J Clin Epidemiol. 2005;58(11):1081–8.CrossRef Mills E, Jadad AR, Ross C, Wilson K. Systematic review of qualitative studies exploring parental beliefs and attitudes toward childhood vaccination identifies common barriers to vaccination. J Clin Epidemiol. 2005;58(11):1081–8.CrossRef
26.
go back to reference Whyte MD, Whyte J, Cormier E, Eccles D. Factors influencing parental decision making when parents choose to deviate from the standard pediatric immunization schedule. J Community Health Nurs. 2011;28(4):204–14.CrossRef Whyte MD, Whyte J, Cormier E, Eccles D. Factors influencing parental decision making when parents choose to deviate from the standard pediatric immunization schedule. J Community Health Nurs. 2011;28(4):204–14.CrossRef
27.
go back to reference Stefanoff P, Mamelund S, Robinson M, Netterlid E, Tuells J, Bergsaker MAR, et al. Tracking parental attitudes on vaccination across European countries: The Vaccine Safety, Attitudes, Training and Communication Project (VACSATC). Vaccine. 2010;28(35):5731–7.CrossRef Stefanoff P, Mamelund S, Robinson M, Netterlid E, Tuells J, Bergsaker MAR, et al. Tracking parental attitudes on vaccination across European countries: The Vaccine Safety, Attitudes, Training and Communication Project (VACSATC). Vaccine. 2010;28(35):5731–7.CrossRef
28.
go back to reference Gullion JS, Henry L, Gullion G. Deciding to opt out of childhood vaccination mandates. Public Health Nurs. 2008;25(5):401–8.CrossRef Gullion JS, Henry L, Gullion G. Deciding to opt out of childhood vaccination mandates. Public Health Nurs. 2008;25(5):401–8.CrossRef
29.
go back to reference Niederhauser VP, Markowitz M. Barriers to immunizations: multiethnic parents of under- and unimmunized children speak. J Am Acad Nurse Pract. 2007;19(1):15–23.CrossRef Niederhauser VP, Markowitz M. Barriers to immunizations: multiethnic parents of under- and unimmunized children speak. J Am Acad Nurse Pract. 2007;19(1):15–23.CrossRef
30.
go back to reference Dannetun E, Tegnell A, Hermansson G, Giesecke J. Parents’ reported reasons for avoiding MMR vaccination. Scand J Prim Health Care. 2005;23(3):149–53.CrossRef Dannetun E, Tegnell A, Hermansson G, Giesecke J. Parents’ reported reasons for avoiding MMR vaccination. Scand J Prim Health Care. 2005;23(3):149–53.CrossRef
31.
go back to reference Hill MC, Cox CL. Influencing factors in MMR immunisation decision making. Br J Nurs. 2013;22(15):893–8.CrossRef Hill MC, Cox CL. Influencing factors in MMR immunisation decision making. Br J Nurs. 2013;22(15):893–8.CrossRef
32.
go back to reference O'Malley L, Adair P, Burnside G, Robinson L, Coffey M, Pine C. An evaluation of a storybook targeting parental attitudes, intention, and self-efficacy to change their child's oral health behavior. Health Psychol. 2017;36(2):152.CrossRef O'Malley L, Adair P, Burnside G, Robinson L, Coffey M, Pine C. An evaluation of a storybook targeting parental attitudes, intention, and self-efficacy to change their child's oral health behavior. Health Psychol. 2017;36(2):152.CrossRef
Metadata
Title
Maternal perceptions of childhood vaccination: explanations of reasons for and against vaccination
Authors
Deborah A. McNeil
Melissa Mueller
Shannon MacDonald
Sheila McDonald
Vineet Saini
James D. Kellner
Suzanne Tough
Publication date
01-12-2019
Publisher
BioMed Central
Keyword
Vaccination
Published in
BMC Public Health / Issue 1/2019
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-018-6338-0

Other articles of this Issue 1/2019

BMC Public Health 1/2019 Go to the issue