Communicating Effectively About Vaccines
Summary of a Survey of U.S. Parents and Guardians
With morbidity and mortality from vaccine-preventable diseases [VPDs] having reached record
lows, vaccines are one of the most successful tools for biomedical science and public health. Yet
paradoxically, the effectiveness of vaccination has led to the reemergence of anti-vaccination
sentiments. Vaccines may be seen unnecessary or dangerous because incidence rates of VPDs in
developed countries have plummeted. Vaccine “reactions” – negative health events following
vaccination, attributed to the vaccine – then appear to be more common than the diseases
themselves. In this way, vaccines can be considered victims of their own success. 1
Immunization rates continue to be high but concerns about vaccine safety are increasing. Current
communication methods do not appear to lead to more comfort with vaccines, making it more
important than ever that state and territorial public health agencies, charged with promoting,
monitoring and tracking vaccine use, understand the growing reluctance among parents and guardians
to fully vaccinate their children and identify effective messages about the benefits of vaccines.
In August 2009, ASTHO commissioned a survey of 1,278 U.S. parents and guardians to gather
information about effective messages and materials for addressing parental concerns, support more
informed decisions on the part of parents and guardians, and how best to clearly and accurately
promote the benefits of vaccines in ways that resonate with family decision makers. The study was
designed to explore:
•
•
•
The reasons parents and guardians have for not vaccinating their children
The most effective messages for addressing this resistance
Information sources about vaccines that are the most trusted and influential.
An additional objective was to understand the characteristics that distinguish parents who vaccinate
from those who refuse, including their demographics, attitudes and beliefs, and responsiveness to
messages for and against childhood vaccinations.
This paper is a summary of the findings from the ASTHO study.
Methods
During a two week period in August 2009, interviews were conducted online using an established survey
panel. Interviews averaged 25 minutes in duration. To qualify for the survey, respondents had to live in
the United States with a child under the age of 18, and be responsible for decisions about the health
care the child receives. The sample was weighted to be demographically representative of the U.S.
population of households with children under 18 years with respect to geography, age of the
respondent, presence of children under 6 years, race and ethnicity, household income, and child’s
health insurance status.
To better understand differences between parents who vaccinate and those who refuse, the study
included both groups. Refusers were divided into two groups: SIGNIFICANT REFUSERS, who have refused
any of Diphtheria-Tetanus-Pertussis (DTaP), Haemophilus Influenza type B (Hib), Hepatitis B,
Meningococcal, Measles-Mumps-Rubella (MMR), Pneumococcal, Polio, Rotavirus, or Varicella vaccines;
and MINOR REFUSERS who have refused any of Hepatitis A, Human Papillomavirus (HPV) or Influenza
vaccines. Vaccines for the MINOR REFUSERS category were chosen because most states do not have
school entry requirements for these vaccines, allowing parents to elect to not vaccinate their children
without encountering substantial obstacles. Vaccines in the SIGNIFICANT REFUSERS category are
required for school entry in most or all states, thus requiring parents to take extra steps to obtain an
exemption.
© 2010 Association of State and Territorial Health Officials
202-371-9090
2231 Crystal Drive, Ste 450, Arlington, VA
www.ASTHO.org
1
Communicating Effectively About Vaccines
Summary of a Survey of U.S. Parents and Guardians
Respondents whose children had received at least one vaccine were further grouped according to:
•
Major concerns, including those who self-identified as being “very uncomfortable/unconfident”
or “not comfortable/confident” about children receiving vaccinations
•
Minor concerns, including those who self-identified as being “comfortable/confident” about
children receiving vaccinations
•
No concerns, including those who self-identified as being “very comfortable/confident” about
children receiving vaccinations
Respondents were blinded as to which category they were grouped into; determinations were made by
the survey tool based on their responses to which vaccines they refused and, if their child had received
all vaccines, their level of comfort with vaccinating.
The majority of the parents surveyed were vaccinators with minor or no concerns (their children had
received all of the recommended vaccines), however, in order to drill down to the issues of parents and
guardians who had refused vaccines, additional interviews with SIGNIFICANT and MINOR REFUSERS
were conducted. To adjust for this over- and under-sampling, the data was weighted so that the total
reflected the actual U.S. population as determined by the survey. See Figure 1 below.
Figure 1. Survey sample and actual U.S. population.
Survey Sample
Actual Population
Vaccinators with
No Concerns
19%
28%
Significant
Refusers
Vaccinators with
No Concerns
36%
43%
Minor Refusers
24%
13%
16%
Vaccinators with
Major Concerns
Vaccinators with
Minor Concerns
© 2010 Association of State and Territorial Health Officials
202-371-9090
5%
6% 10%
Significant
Refusers
Minor Refusers
Vaccinators with
Major Concerns
Vaccinators with
Minor Concerns
2231 Crystal Drive, Ste 450, Arlington, VA
www.ASTHO.org
2
Communicating Effectively About Vaccines
Summary of a Survey of U.S. Parents and Guardians
Regardless of the vaccination status of the child in their care, all respondents answered all following
survey questions, including questions about vaccine exemptions; whether and why vaccines may have
been delayed (if not refused); attitudes about government, vaccine requirements, and vaccine risks and
benefits; messages about vaccines; messengers for vaccine-related messages; and sources of vaccine
information.
Results
Refusing and Delaying Vaccines
Of those surveyed, 47% reported being very comfortable/confident with their children receiving
vaccinations, 43% were comfortable/confident, while 8% were not comfortable/confident, and 2% were
very uncomfortable. Interestingly, the majority of both SIGNIFICANT REFUSERS and MINOR REFUSERS
said they were very comfortable (25% for both groups) or comfortable (38% and 46% respectively)
about their children receiving vaccinations, although the percentages are lower than among
VACCINATORS WITH NO CONCERNS.
Among all respondents, 16% have refused a vaccine. Of these, 6% are MINOR REFUSERS (who refused
only HepA, HPV or Flu) and 10% are SIGNIFICANT REFUSERS. Influenza and HPV being the most
commonly refused (8% each), followed by Varicella (5%) and other vaccines at 2-3%.
Additionally, 13% have delayed a vaccine, with DTaP being the most commonly delayed (4% of
respondents) and other vaccines at 2-3%. People who refused Hib or Polio vaccines were mostly likely to
refuse other vaccines as well, while those who refused HPV or influenza refused the fewest other
vaccines.
The most common reason across all categories of respondents for delaying or refusing vaccines was
concern about too many vaccines being given at the same time. Additional reasons for delaying vaccines
are found in Figure 2.
Figure 2. Reasons for Delaying or Refusing Vaccines.
Stated reasons for delaying or refusing
vaccines
Total
Significant
Refuser
Minor
Refuser
Vax-Major
Concern
VaxMinor
Concern
Vax-No
Concern
Unweighted Base
(278)
(130)
(57)
(47)
(31)
(13)
53%
59%
66%
51%
51%
35%
12
14
6
12
15
8
Child was sick
9
8
2
23
11
5
Family/friend recommended delaying
5
7
3
12
4
0
Other (Grand Net)
33
32
35
30
30
37
Insurance Concerns (Net)
3
0
2
1
3
10
Had no insurance
2
0
1
1
0
10
% Selecting Each Reason
Did not want too many vaccines given at
same time
Doctor recommended delaying the
vaccine
© 2010 Association of State and Territorial Health Officials
202-371-9090
2231 Crystal Drive, Ste 450, Arlington, VA
www.ASTHO.org
3
Communicating Effectively About Vaccines
Summary of a Survey of U.S. Parents and Guardians
Stated reasons for delaying or refusing
vaccines
Total
Significant
Refuser
Minor
Refuser
Vax-Major
Concern
VaxMinor
Concern
Vax-No
Concern
Not covered by our insurance
1
0
1
0
3
0
Safety Concerns (Net)
9
9
18
10
10
0
Concerned about side effects
4
3
3
0
10
0
Risk of autism
2
3
2
4
0
0
Too new
1
0
5
0
0
0
Other safety concerns
3
4
8
8
0
0
Unnecessary (Net)
4
4
6
9
2
0
Wait for child to acquire it naturally
2
2
1
7
0
0
Didn’t think it was necessary
2
1
5
1
2
0
My own research/ research myself
4
5
2
2
0
8
Waiting for the child to be older
3
3
5
0
4
0
Not comfortable with it
2
5
3
0
2
0
Miscellaneous
Profiles of Respondents
Demographic Profile
Overall, we found few significant demographic differences across the categories. The SIGNIFICANT
REFUSERS tend to be better educated, and have slightly higher household incomes than other groups.
MINOR REFUSERS tend to have older, rather than younger children, which we suggest may be related to
refusal of HPV vaccine, though we did not ask this question. VACCINATORS WITH MAJOR CONCERNS
include a higher percentage of African-Americans, a lower percentage of Whites, and are less likely to be
employed. Conversely, VACCINATORS WITH MINOR CONCERNS include a lower percentage of AfricanAmericans and Hispanics, and a higher percentage of Whites.
Geographic Profile
We found considerable geographic differences in the distribution of the categories. There are more
SIGNIFICANT REFUSERS in the Pacific states (14%) (CA, OR, WA). There are fewer SIGNIFICANT REFUSERS
and more VACCINATORS WITH MINOR CONCERNS in East South Central states (4% and 51%) (KY, TN,
MS, AL) and West North Central states (5% and 46%)(ND, SD, NE, KS, MN, IA, MO). There are the most
VACCINATORS WITH NO CONCERNS in South Atlantic states (50%)(DE, MD, DC, WV, VA, NC, SC, GA, FL)
and West South Central states (51%)(TX, OK, AR, LA).
Attitudinal Profile
We asked various questions to get a sense of attitudes about government, immunization requirements,
and vaccine risks and benefits. In general, respondents had a positive view about the role of public
health and tended to agree that protecting and improving public health is an important job of the
government. Generally, parents are not well informed about vaccination requirements and exemption
© 2010 Association of State and Territorial Health Officials
202-371-9090
2231 Crystal Drive, Ste 450, Arlington, VA
www.ASTHO.org
4
Communicating Effectively About Vaccines
Summary of a Survey of U.S. Parents and Guardians
options. Only 27% of VACCINATORS WITH MAJOR CONCERNS and 28% of VACCINATORS WITH MINOR
CONCERNS felt well informed about the exemptions available in their state. By contrast, 52% of
SIGNIFICANT REFUSERS felt well informed about the exemptions.
Opinions about vaccine requirements vary by category. VACCINATORS WITH MINOR or NO CONCERNS
tend to disagree that vaccinations should only be required against the most dangerous diseases, and do
not have concerns about state vaccination requirements. In contrast, VACCINATORS WITH MAJOR
CONCERNS, MINOR CONCERNS and SIGNIFICANT REFUSERS agree that children should only be required
to get vaccinations against the most dangerous diseases, and disagree that the government’s
immunization requirements for children are flexible.
VACCINATORS WITH MAJOR CONCERNS are the most concerned about vaccine safety and the most
likely to feel government does not take vaccine safety concerns seriously enough. Across all categories
of respondents, the most concerning side effects are seizures, encephalopathy, Guillian-Barre
Syndrome, blood clots and intussusception. Least concerning side effects include swollen/sore arm or
leg, fever under 101, headache, drowsiness, or skin reaction.
Vaccine Administration Location
The majority of the children in this survey received their health care and vaccinations at a doctor’s
office, and over 90% receive the majority of their vaccinations at the same place they get most of their
health care. However, SIGNIFICANT REFUSERS are the most likely to use different venues for
vaccinations versus other health care, and they, along with VACCINATORS WITH MAJOR CONCERNS, are
less likely to receive care or vaccinations at doctor’s offices, compared to the other groups.
Reasons for Opposing Vaccinations
Concern about Vaccine Safety and Side Effects: The survey included an open-ended question asking, “In
your own words, please describe the biggest reasons why you, yourself, might oppose vaccinations for
your child or prefer not to have your child vaccinated”. The most common response was concern about
vaccine safety and side effects. VACCINATORS WITH MAJOR CONCERNS and those with MINOR
CONCERNS are both more likely than REFUSERS to mention safety concerns, while those with NO
CONCERNS are least likely to do so. Almost one-fifth of VACCINATORS WITH MAJOR CONCERNS
specifically mention concern about autism, whereas only 5% of parents, overall, mentioned autismrelated concerns. VACCINATORS WITH MAJOR CONCERNS are also the most likely to mention concerns
about giving too many vaccines at the same time.
Lack of Necessity or Trust: SIGNIFICANT REFUSERS were more likely than others to mention that not all
vaccines are necessary – that some diseases are not serious enough to warrant a vaccine, that they
reduce the body’s natural immunity, or they do not trust the vaccines. MINOR REFUSERS are more likely
than others to mention lack of trust (in vaccines and the government), as well as opposition to HPV in
particular. About one-quarter of parents said they do not oppose vaccinations, and over one-third did
not volunteer any reasons not to vaccinate.
Reasons for Supporting Vaccinations
Protecting Their Child’s Health: An open-ended question was posed to parents about why they support
vaccinations for their child, to which the most common reason is to protect their child’s health.
SIGNIFICANT REFUSERS and VACCINATORS WITH MAJOR CONCERS are less likely to mention this than
© 2010 Association of State and Territorial Health Officials
202-371-9090
2231 Crystal Drive, Ste 450, Arlington, VA
www.ASTHO.org
5
Communicating Effectively About Vaccines
Summary of a Survey of U.S. Parents and Guardians
are the other groups; however, it is mentioned by at least 60% of each of these groups. (SIGNIFICANT
REFUSERS – 63%, MINOR REFUSERS – 66%, VACCINATORS WITH MAJOR CONCERNS – 60%,
VACCINATORS WITH MINOR CONCERNS – 76%, VACCINATORS WITH NO CONCERNS – 72%).
Preventing the Spread of Disease: The next most commonly mentioned reason is to prevent the spread of
disease. MINOR REFUSERS are more likely than other parents to mention this, while SIGNIFICANT REFUSERS
and VACCINATORS WITH MAJOR CONCERNS are again less likely to mention it. About 10% of parents mention
that vaccines are required by the government or recommended by their doctors. VACCINATORS WITH MAJOR
CONCERNS are particularly likely to mention requirements for school admission.
Messages
Negative Messages
The respondents were given a list of negative messages about vaccines and asked to rate whether they
had previously heard it, and whether each was believable and convincing. The negative messages tested
that were ranked as the most believable and the most convincing all have to do with risks of adverse
effects. The messages were:
•
•
•
•
Vaccines can cause serious health problems, like auto-immune disorders, asthma or autism.
Vaccines are unsafe due to ingredients such as thimerosal or aluminum.
Too many vaccines given too soon can harm children.
Combination vaccines are more likely to cause adverse reactions.
There was little difference across categories in their ratings of the negative messages, or in their ranking
of the most convincing arguments. See Figure 3.
Positive Messages
Generally, positive messages about vaccination are rated as much more convincing and much more
believable than the negative messages, as well as more familiar. The most compelling positive message
(also the most believable and the most familiar) is that “Vaccination is one of the most important ways I
can protect my child.”
The least compelling positive message (also the least believable and the least familiar) is that “Scientific
studies do not support the concern that thimerosal causes autism.”
There was little difference across categories in the ratings of the positive arguments, or the ranking of
the most convincing arguments. See Figure 4.
© 2010 Association of State and Territorial Health Officials
202-371-9090
2231 Crystal Drive, Ste 450, Arlington, VA
www.ASTHO.org
6
Communicating Effectively About Vaccines
Summary of a Survey of U.S. Parents and Guardians
Figure 3. Negative Messages about Vaccinations.
© 2010 Association of State and Territorial Health Officials
202-371-9090
2231 Crystal Drive, Ste 450, Arlington, VA
www.ASTHO.org
7
Communicating Effectively About Vaccines
Summary of a Survey of U.S. Parents and Guardians
Figure 4. Positive Messages about Vaccinations.
Influencers
In an effort to better understand what most influences a parent’s decision on vaccines, participants
were asked to identify the sources of influence. Parents typically give themselves over half of the
“votes”, and their spouses about a quarter of the votes, as to whether their child receives vaccines. The
other major influence is the pediatrician, who has less influence than the parents. SIGNIFICANT
REFUSERS give slightly less influence to pediatricians, while VACCINATORS WITH MAJOR CONCERNS give
slightly more influence to pediatricians, and slightly less influence to themselves.
Pediatricians and spouses are generally the most used and influential sources. Nurses and CDC are
additional sources and are influential among VACCINATORS WITH MINOR or NO CONCERNS, but are less
so among the other groups. Websites are commonly used by all segments except VACCINATORS WITH
NO CONCERNS, but are not very influential.
© 2010 Association of State and Territorial Health Officials
202-371-9090
2231 Crystal Drive, Ste 450, Arlington, VA
www.ASTHO.org
8
Communicating Effectively About Vaccines
Summary of a Survey of U.S. Parents and Guardians
Figure 5. Information Sources about Vaccinating Children.
Significant
Refusers
Used &
Influential
Vax-Major
Concerns
Vax-Minor
Concerns
Vax-No
Concerns
Pediatrician
Spouse
Pediatrician
Spouse
Pediatrician
Spouse
Nurse
CDC
Pediatrician
Nurse
Public Health
Officials
CDC
Websites
Public Health
Officials
CDC
School Officials
Other family
Nurse
Websites
Grandparents
Parenting experts
Grandparents
Non-government
health orgs
Public health
officials
Minor Refusers
Pediatrician
Spouse
Used, but Not
Influential
Websites
Nurse
CDC
Websites
Nurse
Public Health
Officials
Influential,
but not used
Expert in alternative
medicine
Books
CDC
Blogs/on-line
forums
Grandparents
TV/Radio
Programs
Participants were asked, “of the convincing reasons for vaccinating your child, what is the most
convincing source of the messages?” Responses indicated that pediatricians are by far the most
convincing source of positive messages about vaccination, followed by the CDC and Public Health
Officials.
Figure 6. Most Convincing Positive Message Sources. (% selecting as “most convincing source”)
Protect Child
(n=448)
Disease still a
threat (n=217)
Most
Influential
Pediatrician
(87%)
Moderately
Influential
CDC (26%)
Pediatrician
(52%)
CDC (39%)
Public Health
Officials(23%)
Somewhat
Influential
Public Health
Officials
(13%)
Non-Govt
Health Orgs
(14%)
Prevent Disease
Episodes
(n=163)
Pediatrician
(66%)
CDC (40%)
Public Health
Off (21%)
Non-Gov Health
Orgs
(13%)
Wipe out
Diseases
(n=150)
Pediatrician
(65%)
CDC (36%)
Public Health
Off (16%)
Websites (11%)
Non-Gov
Health Orgs
(10%)
Social
Obligation
(n=123)
Pediatrician
(70%)
CDC (26%)
Public Health
Off (21%)
Spouse (14%)
Studies Show
Vaccines are
Safe (n=119)
Pediatrician
(71%)
CDC (42%)
Public Health
Off (32%)
Non-Gov
Health Orgs
(14%)
Expert in
alternative
medicine
(12%)
Parents generally believe their pediatricians support vaccinations. However, they are less likely to
believe that their pediatricians are well-informed about childhood vaccinations or spend sufficient time
with them explaining risks and benefits of vaccinations. Additionally, 53% of VACCINATORS WITH
MAJOR CONCERNS felt that their child’s doctor did not take enough time to explain the risks and
benefits of vaccinations.
© 2010 Association of State and Territorial Health Officials
202-371-9090
2231 Crystal Drive, Ste 450, Arlington, VA
www.ASTHO.org
9
Communicating Effectively About Vaccines
Summary of a Survey of U.S. Parents and Guardians
Discussion
The results of this survey support other findings in that the majority of parents continue to fully
vaccinate their children and are comfortable with the benefits of vaccines. This study found that 90% of
the respondents were either very comfortable or comfortable with their children receiving vaccinations.
A study conducted in 2005 found 84% of parents agreed or strongly agreed that vaccines are necessary. 2
A study in 2000 found 87% deemed immunization an extremely important action that parents can take
to keep their children well. 3
This research is also consistent with other studies, however, that have found that parents continue to
have concerns about vaccine safety. The most common reason given by parents not to vaccinate was
the risk of adverse effects. Misconceptions about immunizations continue. For example, concerns about
thimerosal continue to be high and messages that scientific studies do not support the concern are the
least convincing and least believable of the messages tested. These findings indicate that factors other
than current scientific facts contribute to the decision making process.
…more consideration must be given to the social discourses underlying anti-vaccinationismreasons for refusing vaccines may involve alternative understandings of health, different
perspectives on parental responsibility, or questioning the legitimacy of traditional authorities.
These discourses exemplify postmodern tensions in society, making the anti-vaccination issue
one of significant complexity. 4
All parents, except VACCINATORS WITH NO CONCERNS, were concerned by messages such as, “vaccines
can cause serious health problems like auto-immune disorders, asthma or autism” and “too many
vaccines given too soon can harm children.” The challenge for public health is how to effectively address
these underlying concerns so that they do not lead to more parents delaying or refusing vaccines.
Positive messages were
generally rated as more
convincing and more
believable than negative
messages. For instance:
“Vaccination is one of the most
important ways you can
protect your child from lifethreatening illness and it’s the
best-known protection against
a number of infectious
diseases.”
A telephone survey in 2000 found that between 19% and 25% of
parents surveyed have misconceptions about immunizations. 5 A
recent study entitled, “Parental Vaccine Safety Concerns in 2009”
found that over half of their respondents expressed concerns
regarding serious adverse effects. 6
The ASTHO research found 16% of respondents refused a vaccine,
while 13% have delayed a vaccine. The refusal rate is higher
compared to previous studies, such as a 2009 study by Freed et al.,
which found an 11% refusal rate. Our study is the first recent study
to include influenza vaccine, which may have contributed to the
higher refusal rate in our study. If a parent refused the influenza
vaccine one year for their child, it was recorded as refusing a
vaccine.
The study also found that positive messages were generally rated as more convincing and more
believable than negative messages. The positive message that resonated with the SIGNIFICANT AND
MINOR REFUSERS, and with VACCINATORS WITH MINOR OR NO CONCERNS was that “vaccination is one
of the most important ways I can protect my child from life-threatening illness and it’s the best-known
protection against a number of infectious diseases.” It may seem effective to confront negative
messages about vaccines with negative messages about, for example, the consequences about not
© 2010 Association of State and Territorial Health Officials
202-371-9090
2231 Crystal Drive, Ste 450, Arlington, VA
www.ASTHO.org
10
Communicating Effectively About Vaccines
Summary of a Survey of U.S. Parents and Guardians
vaccinating, but such messages did not test well in our study, and caution may be warranted in using
this approach.
Demographic information about vaccine refusers and vaccine concerns is essentially consistent with past
work, with one variation. The basic finding is that there are few significant demographic differences
across parent groups. In contrast to a 2005 study on immunization attitudes and beliefs, this survey
found that SIGNIFICANT REFUSERS tend to be better educated and
have slightly higher household incomes than the other groups. The
The study found that
2005
study found that parents in the category labeled “fully
VACCINATORS WITH MAJOR
vaccinated
with concerns” tended to have college degrees, higher
CONCERNS were less likely to
income, and private medical care. 7 Comparing these two findings
have private health
may indicate that college educated, higher income groups have
insurance and less likely to
moved from vaccinating their children despite concerns, to now
receive care or vaccinations
refusing vaccines.
at a doctor’s office.
Another interesting, though perhaps not surprising, finding is that
VACCINATORS WITH MAJOR CONCERNS are less likely to have private health insurance and less likely to
receive care or vaccinations at a doctor’s office. The above mentioned 2005 study also found that not
having a regular doctor resulted in delayed immunizations. 8
Finally, this study found that the most influential source of information about vaccinations, aside from
parents, is pediatricians. This is consistent with other findings. In the report on “Do Parents Understand
Immunizations?” the authors state,
Because health care providers are perceived by parents to be the most important source of
information about communications – they have an opportunity and obligation to educate
parents and correct misconceptions. 9
As was pointed out above, 53% of VACCINATORS WITH MAJOR CONCERNS felt that their child’s doctor
did not take enough time to explain the risks and benefits of vaccinations. CDC and professional
organizations are looking into ways to facilitate these communications.
Conclusion
The results of this survey bolster the notion that a strong majority of parents support vaccinations, but
continue to have concerns about their safety and the potential for adverse effects. The fear of disease is
not as prevalent as it was in the past, so convincing parents that vaccines continue to be necessary is an
ongoing challenge.
While immunization rates continue to be high, concerns about vaccine safety are increasing. Current
communication methods based on scientific research do not appear to lead to more comfort with
vaccines. The results of this survey suggest that pediatricians, public health officials and the Centers for
Disease Control and Prevention are seen as reliable sources of information on vaccine issues. With a
better understanding of which messages resonate with the public about the benefits of vaccines, public
health officials can tailor their communications in a way to address the concerns of parents along the
spectrum.
If public health officials and providers can succeed in communicating the benefits of vaccines, then the
country can continue to maintain high rates of coverage and avoid unnecessary loss of life due to
© 2010 Association of State and Territorial Health Officials
202-371-9090
2231 Crystal Drive, Ste 450, Arlington, VA
www.ASTHO.org
11
Communicating Effectively About Vaccines
Summary of a Survey of U.S. Parents and Guardians
vaccine preventable diseases. As stated by Freed and colleagues,
Although information is available to address many vaccine safety concerns, such information is
not reaching parents in an effective or convincing manner. Public health officials should
construct and redesign vaccine information programs to address current safety concerns in a
manner that is more targeted and tailored to specific subgroups of parents. 10
1
Kata, Anna. A postmodern Pandora’s box: Anti-vaccination misinformation on the Internet. Vaccine 28 (2010)
1709-1716.
2
Gust et al. American Journal of Health Behavior, 2005; 29(1):81-92. Immunization Attitudes and Beliefs Among
Parents: Beyond a Dichotomous Perspective. P. 89.
3
Gellin, Bruce, et al. Do Parents Understand Immunizations? A National Telephone Survey. Pediatrics, Volume
106, Number 5, November 2000. p- 1097.
4
Kata, page 1715.
5
Gellin et al,
6
Freed, Gary et al. Parental Vaccine Safety Concerns in 2009. Pediatrics, Volume 125, Number 4, April 2010.
7
Gust et al.
8
Gust et al.
9
Gellin et al, pg 1101.
10
Freed, et al. P 658.
© 2010 Association of State and Territorial Health Officials
202-371-9090
2231 Crystal Drive, Ste 450, Arlington, VA
www.ASTHO.org
12