Factors Influencing Mothers’ Concerns about Immunization Safety
Immunizations have drastically reduced childhood morbidity and mortality from vaccine-preventable disease. One outcome of this success is the majority of parents and healthcare providers are no longer exposed to the diseases that vaccines prevent, and there has been an increasing focus on vaccine safety. Concerns about vaccine safety may negatively affect parents’ decisions to immunize their children, resulting in decreased coverage and, potentially, disease outbreaks. Several studies conclude that parental vaccine attitudes and beliefs affect immunization behaviors, such as late receipt of vaccines and under-immunization. Controversy about vaccine safety has also been shown to cause concern even in those parents who are currently immunizing their children.
African-American children have lower immunization coverage compared with other race groups. There is also evidence that this disparity in coverage between African-American and white children is widening. Reasons for this disparity are complex and not completely understood, but they are usually attributed to sociodemographic factors, such as poverty and access to care. However, even when socioeconomic differences are considered, the disparity persists. Currently, there is little research that specifically assesses African-American parents’ immunization attitudes and concerns and how these attitudes and concerns influence decisions to have their children immunized. One study of mainly inner-city African-American parents in Baltimore found that parents believed vaccines to cause illness and that they did not consider immunization to be a high-priority parental responsibility. Another study which also surveyed mainly African-American parents in inner city Baltimore found that parents’ knowledge and attitudes about immunization did not explain their child’s immunization status as much as sociodemographic characteristics. However, both of these “African-American” will refer to non-Hispanic African-American race throughout the paper and “white” will refer to non-Hispanic white race throughout the paper. buy vardenafil online
Studies were set in a single metropolitan area and were done more than a decade ago when vaccine safety concerns may have been less prominent.
Recent preliminary analyses of the National Immunization Survey-Knowledge Attitudes and Practices module revealed that a greater proportion of African-American parents sampled reported being very concerned about childhood vaccine safety compared with white parents (64% vs. 19%, respectively; p<0.05) (CDC, unpublished data). However, further analysis showed that this high level of concern among African-American parents did not translate into lower rates of immunization; only 7% of African-American parents with high levels of concern had a child who was underimmunized compared with 21 % of African-American parents who did not report a high level of concern (p<0.05) (CDC, unpublished data).
The reasons this high level of concern over immunization safety is present among African-American parents who are getting their children immunized remain unclear. Although these parents are currently having their children immunized, it is important to understand and address their concerns in order to prevent these parents or other parents with similar concerns from ceasing to immunize. Raithatha et al. conceptualize the decisions parents make about having their child immunized through a vaccine risk threshold. They found that vaccine risk acceptability was affected by a number of factors, including not only parental perceived susceptibility to infection but also parental attitudes to the immunization process and their trust in the risk managers [government/healthcare provider(s) (HCPs)]. When parents’ overall attitudes about the “risk unacceptability” of a vaccine move above a theoretical threshold they will cease to immunize. They discuss how controversy in the United Kingdom over the safety of measles-mumps-rubella vaccine (MMR) may have triggered a reappraisal of risk, leading many parents to move above the threshold level and cease immunizing their children. generic tadalafil 20mg
Thus, we conducted this focus group study to discover the reasons African-American mothers had a high level of concern about childhood vaccines and to understand why they had their children immunized despite their concerns. As in this study, focus groups are often used to provide insight about the meaning and interpretation of quantitative survey results.