Journal
VACCINE
Volume 28, Issue 26, Pages 4235-4248Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.vaccine.2010.04.052
Keywords
Decision-making; Parents; MMR; Vaccination; Immunization
Categories
Funding
- Health Protection Agency
- National Institute of Health Research
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Suboptimal childhood vaccination uptake results in disease outbreaks, and in developed countries is largely attributable to parental choice. To inform evidence-based interventions, we conducted a systematic review of factors underlying parental vaccination decisions. Thirty-one studies were reviewed. Outcomes and methods are disparate, which limits synthesis; however parents are consistently shown to act in line with their attitudes to combination childhood vaccinations. Vaccine-declining parents believe that vaccines are unsafe and ineffective and that the diseases they are given to prevent are mild and uncommon; they mistrust their health professionals, Government and officially-endorsed vaccine research but trust media and non-official information sources and resent perceived pressure to risk their own child's safety for public health benefit. Interventions should focus on detailed decision mechanisms including disease-related anticipated regret and perception of anecdotal information as statistically representative. Self-reported vaccine uptake, retrospective attitude assessment and unrepresentative samples limit the reliability of reviewed data - methodological improvements are required in this area. (C) 2010 Elsevier Ltd. All rights reserved.
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