Exploring the choice to refuse or delay vaccines: a national survey of parents of 6- through 23-month-olds

Acad Pediatr. Sep-Oct 2012;12(5):375-83. doi: 10.1016/j.acap.2012.06.007. Epub 2012 Aug 22.


Objective: The purpose of this study was to assess respondents' self-reported choices for vaccinating their young children; knowledge, attitudes, and beliefs (KABs) about vaccination; and communication with their child's vaccination provider.

Methods: A national telephone survey of 1500 parents of children aged 6 to 23 months was conducted in 2010. We calculated proportions of parents who had chosen-or planned-to refuse or delay 1 or more recommended vaccines, and proportions for responses to KABs and communication questions, stratified by vaccination choice (ie, refuse or delay).

Results: The response rate was 46%. Among the 96.6% of respondents (95% confidence interval [CI], 95.5%-97.4%; weighted n = 1453) who had chosen for their child to receive at least 1 vaccine, 80.6% (95% CI, 78.8%-83.0%) reported that their child had received all vaccines when recommended and 86.5% (95% CI, 84.7%-88.2%) reported that their child would receive remaining vaccines when recommended. Respondents who considered not following recommendations, but ultimately did, cited the physician's recommendation as the reason for vaccinating. Most vaccinators who reported past or planned deviations from recommendations cited only 1 vaccine that they would refuse and/or delay; all vaccines were mentioned. These parents reported approaching vaccination with serious concerns, while believing other parents did not. All parents cited "vaccine side effects" as their top question or concern. Almost all parents talked to a doctor or nurse about vaccines and, overall, satisfaction with communication was high.

Conclusions: Communication about vaccines is important to most parents, but may be challenging for providers, because parental choices vary; thus, efforts to improve and support vaccine communication by providers should continue.

MeSH terms

  • Adult
  • Choice Behavior*
  • Communication
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Infant
  • Nurses
  • Parents / psychology*
  • Physicians
  • Professional-Family Relations
  • Time Factors
  • Treatment Refusal / psychology*
  • Treatment Refusal / statistics & numerical data
  • Vaccination / psychology*
  • Vaccination / statistics & numerical data
  • Vaccines / administration & dosage*
  • Vaccines / adverse effects


  • Vaccines