How parents make decisions about their children's vaccinations

Background: Continued parental acceptance of childhood vaccination is essential for the maintenance of herd immunity and disease prevention. As such, understanding parents' decision-making in relation to their children's vaccinations is vitally important. Objective: This qualitative study sought to develop an understanding of the general process parents go through when making decisions about their children's vaccinations. Methods: Interviews were conducted with U.S.-born parents living in King County, Washington who had children <= 18 months of age. These interviews were recorded and transcribed verbatim. Results: Through the application of grounded theory, a general decision-making process was identified. Stages in this process included: awareness, assessing and choosing, followed by either stasis or ongoing assessment. The greatest variation occurred during the assessing stage, which involved parents examining vaccination-related issues to make subsequent decisions. This research suggests that three general assessment groups exist: acceptors, who rely primarily on general social norms to make their vaccination decisions; reliers, who rely primarily another people for information and advice; and searchers, who seek for information on their own, primarily from published sources. Conclusions: These results imply that one-size-fits-all approaches to vaccination interventions are inappropriate. Instead, this research suggests that interventions must be targeted to parents based on how they assess vaccination. (C) 2013 Elsevier Ltd. All rights reserved.