Abstract
BackgroundUnderstanding reasons for and against vaccination from the parental perspective is critical for designing vaccination campaigns and informing other interventions to increase vaccination uptake in Canada. The objective of this study was to understand maternal vaccination decision making for children.MethodsMothers participating in a longitudinal community-based pregnancy cohort, the All Our Babies study in Calgary, Alberta, completed open-ended survey questions providing explanations for the vaccination status of their child by 24 months postpartum. Qualitative responses were linked to administrative vaccination records to examine survey responses and recorded child vaccination status.ResultsThere were 1560 open-ended responses available; 89% (n = 1391) provided explanations for vaccinating their children, 5% (n = 79) provided explanations for not vaccinating/delaying, and 6% (n = 90) provided explanations for both. Themes were similar for those vaccinating and not vaccinating/delaying; however, interpretations were different. Two broad themes were identified: Sources of influence and Deliberative Processes. Sources of influence on decision making included personal, family, and external experiences. Deliberative Processes included risk, research, effectiveness, and balancing risks/benefits. Under Deliberative Processes, responsibility was a category for those vaccinating; while choice, instrumental/practical, and health issues were categories for those not vaccinating/delaying. Mothers’ levels of conviction and motivation provided a Context for understanding their decision making perspectives.ConclusionsVaccination decision making is complex and impacted by many factors that are similar but contribute to different decisions depending on mothers’ perspectives. The results of this study indicate the need to examine new intervention approaches to increase uptake that recognize and address feelings of pressure and parental commitment to choice.
Highlights
Vaccination contributes to significant reductions in communicable disease [1]
Survey data was obtained from the All Our Babies study (AOB), an ongoing longitudinal pregnancy cohort study in Calgary, Alberta [7]
The AOB 24 month questionnaire, which was used for analysis, included both closed and open-ended questions on a variety of health topics, including childhood vaccinations
Summary
Vaccination contributes to significant reductions in communicable disease [1]. Declining vaccination rates may be due to parental concerns resulting in increases in preventable disease [2]. Parents may choose to vaccinate their child or not as they prefer. Vaccinations are publicly-funded requiring no personal payment nor health insurance. Public health nurses provide vaccinations in community-based clinics throughout the province, for example, the City of McNeil et al BMC Public Health (2019) 19:49. Understanding reasons for and against vaccination from the parental perspective is critical for designing vaccination campaigns and informing other interventions to increase vaccination uptake in Canada. The objective of this study was to understand maternal vaccination decision making for children
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