Parental vaccine attitudes, beliefs, and practices: initial evidence in California after a vaccine policy change

Hum Vaccin Immunother. 2021 Jun 3;17(6):1675-1680. doi: 10.1080/21645515.2020.1839293. Epub 2020 Nov 24.


Senate Bill 277 (SB277) eliminated nonmedical exemptions for school-entry vaccines in California, but the impact of parental vaccine knowledge, attitudes, and beliefs on vaccine decision-making has not been extensively examined within the post-SB277 context. This study generates preliminary understanding and discussion of the vaccination knowledge, attitudes, and beliefs among a pilot population of parents of kindergarten students in California after the implementation of SB277. School officials administered a cross-sectional survey to parents of kindergarten children in California from April to July 2019. Parents reported their perceptions of diseases and vaccines, key immunization beliefs, and confidence in different sources of vaccine information. Most parents (92%) had fully vaccinated their children post-SB277 and generally perceived vaccines to be safe and effective, but about 44% reported they were hesitant about childhood vaccines. The majority of parents (87%) rated vaccine information from their doctor as highly credible. This pilot group of kindergarten parents was generally supportive of vaccination and had fully vaccinated their children, but most parents still harbored concerns and misconceptions about vaccines and about public health authorities. This indicates a disconnect between parental vaccine compliance and confidence, and suggests that educational interventions could impact parental vaccine behavior and decision-making.

Keywords: California; Vaccine hesitancy; infectious disease; school immunization law; state law; vaccine policy.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Attitude
  • California
  • Child
  • Cross-Sectional Studies
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Parents
  • Policy
  • Vaccination
  • Vaccines*


  • Vaccines