What Parents Don’t Know About Childhood VaccinesAugust 5, 2014 by Kathleen Irwin
From “anti-vaxx” advocates such as Jenny McCarthy to organizations making dubious links between childhood vaccines and lifelong health issues, it’s unsurprising that some parents have mixed feelings about the sixteen childhood vaccinations recommended by the CDC.
An unprecedented number of parents are refusing or delaying their children’s vaccinations, which has been driving up the rate of preventable diseases and reducing herd immunity—and which can have fatal consequences for the children involved. As a result, doctors need to be increasingly aware of parental concerns surrounding vaccines and what strategies they can employ to communicate with hesitant parents.
In recognition of the CDC’s National Immunization Awareness Month, we conducted an online survey of 1,360 parents with children under age 18, to find out what parents know about their children’s vaccination statuses and how doctors can best alleviate vaccine-related anxieties. Here’s what we found.
One-Quarter of Children Not Up-To-Date on Vaccinations
Among parents we surveyed with children under 18 years of age, 90 percent know their children’s vaccination status. Reassuringly, over half of these parents (66 percent) say all of their children are up-to-date with their vaccinations.
Children’s Vaccination Status, as Reported by Parents
However, almost one-quarter of parents are aware that their children are not up-to-date on vaccinations. This is a significantly high percentage, considering the recent prevalence of vaccine-preventable diseases. (Nationally, more than 2.1 million children are not fully vaccinated.)
Ten percent of parents surveyed are unsure if their child has been properly vaccinated—a problem that could be addressed by providing better access to vaccination records.
Only Half of Parents Have Access to Children’s Records
Fifty percent of parents responded that they had easy access to their children’s vaccination records. The other 50 percent confessed that they didn’t have easy access to records, or were unsure of how to access them.
Parents’ Access to Children’s Vaccination Records
Parents who have ready access to vaccination records are more empowered to be involved in their children’s health care. Keeping records readily available can also help prevent over-vaccination down the road—which happens when people lose track of their childhood records and receive the same vaccinations more than once.
Dr. Paul Offit, director of the Vaccine Education Center at the Children’s Hospital of Philadelphia, says that the ideal way of accessing vaccination records would be through national or statewide databases. Currently, the requirements for achieving meaningful use stage three of the HITECH Act focus heavily on improving consumer access to immunization records.
James Daniel, Public Health Coordinator for the Office for the National Coordinator of Health Information Technology (ONC), explains that stages one and two of meaningful use involve a unidirectional exchange of information between electronic medical records (EMRs) and state vaccination registries. The requirements for stage three, he says, will involve a bidirectional exchange—meaning that physicians will submit vaccine information through an EMR system and receive clinical decision support in return.
Meaningful use vaccination data transfer
In advance of stage three, the CDC has funded pilot studies testing a consumer access portal for vaccines in five states. The state of Indiana also funded its own consumer access portal, called MyVaxIndiana, which provided access to 14,909 immunization records in 2012.
For now, says Dr. Offit, the best way for parents to keep track of their children’s vaccinations is by obtaining copies of the records from their pediatrician’s office and storing them safely at home.
One-Quarter Not Informed About Children’s Vaccines
Of course, not all of the responsibility for keeping children properly vaccinated falls on parents. Twenty-eight percent of parents surveyed revealed that their children’s pediatrician had never discussed the importance of childhood vaccinations with them. Another 15 percent of parents were unsure.
Parents Informed About Childhood Vaccines by Pediatrician
One of the reasons, according to Dr. Offit, is that the majority of parents don’t have concerns about vaccinating their children; further, busy pediatricians may not proactively start the discussion, or feel they have the time to answer parents’ questions. Vaccine information sheets, such as the ones offered by the CDC and the Immunization Action Coalition, can be a great way for pediatricians to quickly distribute accurate information.
“There’s no stronger force to recommend vaccines than the physician,” emphasizes Dr. Offit. “If they’re weak on it or say that ‘it’s up to you’, that’s a failure on their part.”
Parents Want Vaccine Information Directly From Doctors
Unsurprisingly, a majority of parents (58 percent) would prefer to receive information about childhood vaccines directly from their child’s pediatrician than through more indirect means. Receiving vaccine information via their pediatrician’s website (19 percent), on a handout or poster in the doctor’s office (15 percent) or through a doctor-recommended media source (8 percent) were ranked as significantly less desirable methods.
Parents’ Preferred Vaccination Information Source
Karen Ernst, director of parent-led advocacy organization Voices for Vaccines, explains that the spread of social media is one reason why pediatricians should discuss vaccines with parents.
“Because the Internet is a huge machine,” she warns, “parents often make their choice about immunization before entering the pediatrician’s office. [Members of] their social network are heavy influencers when it comes to that decision.”
Ernst recommends that parents who find troubling vaccine information bring a copy into their child’s next office visit. Pediatricians need to be ready to discuss these issues with parents, and should be armed with the latest scientific research to dispel vaccine-related myths.
Parents Have Widespread Concerns About Vaccines
We found that parents have multiple concerns about vaccines, including the possibility of long-term side effects (31 percent), not wanting to see their child in pain (29 percent) and short-term side effects (24 percent). The safety of vaccine ingredients concerned only 15 percent of parents.
Parental Concerns About Childhood Vaccines
According to scientific studies, the link between vaccines and autism (a common long-term health concern) has been disproven.
But, states Dr. Offit, “When you’ve rung the bell, when you’ve introduced the idea that vaccines cause autism, it’s hard to unring it.”
He contends that this notion won’t go away until a clear cause for autism is discovered—similar to how myths and false treatments for diabetes disappeared after the discovery of insulin in 1920.
Regrettably, there isn’t much that pediatricians can do to help parents avoid seeing their child in pain. Ernst suggests that parents come prepared with a calm attitude and something for their baby to suck on, such as a pacifier, after a vaccination.
She adds that doctors should take the time to “reassure [parents] that their babies will only be in pain for a moment—but [will be] protected for far, far longer.”
Scientific Evidence Most Persuasive for Parents
Over half of parents surveyed indicated that they would be most likely to keep their children up-to-date on vaccinations if their pediatrician explained the scientific evidence behind the safety of vaccines. Twenty-three percent would be most convinced if their pediatrician directly refuted the link between vaccines and autism.
Most Effective Strategies to Persuade Parents to Vaccinate
Scientific evidence, however, can often be difficult to explain to people without a background in science. Dr. Offit advises that pediatricians assume parents are capable of understanding basic scientific concepts, and try to explain scientific research on about an eighth-grade level.
Just 18 percent and 7 percent of parents, respectively, said they would be persuaded by hearing a real, firsthand account from their doctor of a child who caught a vaccine-preventable illness or by seeing images of a child sick with a vaccine-preventable illness.
“The emotion behind the stories that a doctor can tell,” Ernst notes, “will often stick with a parent far longer than the stats behind the number of children immunized without incident each year.”
Dr. Offit also points out that an emotional appeal may work better than a factual appeal for some parents. For parents who are resistant to the idea of vaccinating, he recommends that pediatricians try to discover what is causing their hesitation and address that problem specifically.
“Frame that answer with some degree of emotion and passion,” he says, and understand that some parents may just be scared.
One final way for pediatricians to promote vaccines, suggests Ernst, is by thanking parents who do decide to immunize their children. By making parents feel like they’re part of protecting their communities and contributing to the eradication of dangerous diseases, a stronger front against false vaccine information can be built.
Dr. Offit speculates that some of the recent hesitation surrounding vaccines has been partially caused by the effectiveness of the vaccines themselves.
Since most parents grew up in an age where catching a vaccine-preventable disease was a thing of the past and have never seen someone afflicted with them, “vaccination [has become] a matter of faith,” he says.
Thus, pediatricians must do their part to help educate parents and put them at ease about their decision to vaccinate their children. According to this survey, we found parents are most receptive to direct communication from pediatricians using scientific evidence to support claims.
By working together, pediatricians and parents can tackle vaccine-related anxieties and increase vaccination rates to help keep children healthier.
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