Hepatitis B Virus (HBV)

Factors Influencing Mothers’ Concerns about Immunization Safety: RESULTS

Reasons for Concerns

Factors influencing mothers’ concerns included doubts about the safety and necessity of vaccines, mistrust of the medical community and lack of information (Table 3).

Concerns about Vaccine Safety and Necessity. Fear of and/or experiences with adverse reactions fueled many concerns about immunization safety. Most mothers were extremely upset about the many relatively common side effects, such as swelling, lumps in the legs, rash and severe crying and pain that their children had experienced. A few mothers had children who had experienced more severe reactions, such as seizures. Hearing about purported adverse effects of vaccines, such as autism, also created safety concerns in some mothers. Finally, because immunization programs have been successful in reducing vaccine-preventable disease, many mothers are no longer familiar with the diseases that immunizations prevent. Mothers remarked that they hadn’t “heard of or seen in ages” many of the vaccine-preventable diseases. This lack of familiarity may have led some mothers to believe that many of the diseases that their children were being vaccinated against were not a serious problem. Other mothers thought that children were getting “too many vaccines” and that vaccines for less severe diseases that were not life threatening, such as the chicken pox, were not necessary.

Table 3. Reasons for Concerns

Safety and Necessity

Experience with reactions

“1 do fear the reactions, the side effects…those lumps in their legs or fevers and all of that. 1 think there should be an alternative.”

Purported adverse events

“[After my son got his shot]…l watched him for a whole year because…1 wanted to make sure that he wasn’t going to have autism or anything.”

“My biggest concern was when 1 started her on the shots that they get when they’re 18 months [was that they] can cause autism so 1 actually delayed my daughter [from] getting that shot because 1 was afraid something like that would happen.”

Lack of necessity

“1 mean so many of the things that we are being vaccinated against 1 haven’t heard of or seen in years, are they still really necessary?”

“…but something like the chicken pox is not going to kill you. If you were dealing with something polio then yes, but 1 think that the medical field is getting to the point where they think more is better and 1 think we need to revert back to less is more.”


Fear of experimentation

“That [Tuskegee] always sticks in my mind. That you really don’t know what’s happening and here these people were guinea pigs and 1 just don’t want my children to be part of that.”

Questionable ingredients

“1 want to know how much in the shot is actually other stuff…because who knows what the government could be giving us.”

“They give you all these papers on the shots your child got…but they never tell you what exactly is inside the shot.”

Lower-quality vaccines for African Americans

“Are they [African-American children] getting the same shots as the Caucasian children are getting from the Caucasian doctors?”

“1 don’t trust them. They might try out the black shot on you.” Financial gain

“1 don’t trust them [doctors]. How do 1 know [they’re not] just telling me this so 1 can get these shots so [they] can get their money.”

Lack of information

General lack of knowledge

“1 can be honest, 1 don’t know everything that they’re getting because 1 don’t even know what all the little letters mean.”

“1 don’t feel like I’m educated at all when it comes to these shots.” Poor communication with HCP

“1 have asked my doctor questions, but she doesn’t answer.”

“1 think healthcare providers are not informing patients and sometimes when you raise too many questions you can see the impatience of doctors not really wanting to answer.”

“Don’t talk to me in doctor terms. 1 didn’t go to medical school. Just talk to me in layman terms and let me know what’s going on with my baby. 1 think that’s more of a reason why 1 don’t have a trust factor.”

Complexity of immunization schedule

“…you give your child the immunization and then [in] two more months it’s the same thing again…What happened to the first one? What’s the reason to have the vaccination this time, this time, this time, when you can get it in one time”

“Why do we have to keep coming back, getting the same shot? 1 only get the flu shot once a year…why do you have to get hepatitis В three times when one time should work?”

Conflicting messages due to vaccine shortages

“They ran out of MMRs and they were supposed to call and reschedule but they never really did…l was kind of concerned because if it’s so important to get done, why don’t they have enough for the babies to get?”

Mistrust. Mistrust of the medical community and government was also prevalent among participants. Many did not consider their HCPs to be partners in the welfare of their children and believed that providers did not always act in their best interests. Knowledge of the Tuskegee Syphilis Study and fear of being experimented on by the government contributed to some mothers’ worries about the vaccine safety. This fear of experimentation was evident in the majority of participants’ desire to know more about vaccine ingredients. Mothers remarked that no one ever told them what chemicals or active ingredients are actually in the shot. Some participants also believed that African-American children were likely to receive lower-quality shots than white children. Other dimensions of mistrust stemmed from beliefs that potential for financial gain could influence the way they were treated by their HCPs. vardenafil 20 mg

Lack of Information. The majority of mothers felt uneducated and underinformed about immunizations. When asked why they were so concerned about having their children immunized, many mothers said they were simply lacking enough knowledge about vaccines to make them comfortable with their decision to immunize. Some mothers seemed to lack an accurate perception of what the actual risks and benefits of vaccination were. One woman remarked, “I mean, what happens if you don’t get the shots?” Another said that it would be useful if someone could explain “what the result of not getting an immunization is.”

Poor communication with their HCPs was tied to mothers’ lack of knowledge about immunizations. Concerns about adverse reactions and the necessity of vaccines could also be attributed to a lack of parental education about the safety and necessity of immunization.

Several mothers expressed a need for better communication to assuage their concerns. Criticisms ranged from not having any of their questions answered to not being able to understand their provider’s medical terminology.  generic tadalafil 20mg

Also related to poor communication and lack of information was that a number of participants expressed concern about the process of immunization. Mothers were uncomfortable about their children “getting so many shots at one time” and wanted explanations about why shots were given at specific times and more than once. Recent vaccine shortages also sent conflicting messages about the importance of following the immunization schedule when mothers would bring their children in for a vaccination and not be able to get it.

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Tags: African-American, immunization safety, mistrust, parental concerns

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