How do mothers’ vaccine attitudes change over time?

Abstract

Although many interventions aim to reduce parents' hesitancy about childhood vaccinations, parents' experiences of vaccine attitude change trajectories remain underexplored. This constructivist grounded theory study examines trajectories of change in vaccine confidence and uptake among mothers in the Greater Vancouver region of Canada. Specifically, we explored what mothers identified as causes and facilitators to these changes, the processes involved, and how they experienced these changes in the contexts of their parenting lives. The study population comprised 23 mothers (mean age 41.3 years), each with at least one child aged 6–12 years. Nine (39%) had become more confident in vaccines, 10 (43%) more hesitant, and four (17%) experienced multiple changes over time. Trajectories of growing vaccine confidence were portrayed by participants as cognitive journeys, moving toward facts and away from fear, and influenced by a participant's growing knowledge and experience. Trajectories of increased hesitancy about vaccination involved underlying concerns about vaccines that were augmented by negative peer attitudes or negative personal experiences with vaccination or health care. In both trajectories, a mother's growing confidence as a parent was perceived as empowering her to make decisions over time. Mothers with multiple changes in vaccine attitudes either had hesitations about specific vaccines, which were allayed over time, or experienced negative vaccine reactions that caused them to pause, then later resume, vaccination.