Abstract
Objectives
This study investigates parental decisions to vaccinate their children against measles, mumps and rubella (MMR). Parent and provider survey data allow the analysis of interactions between these major players in decision making.
Methods
Three datasets are used for analysis: (a) the basic population of the school entry-level health checkup in Munich, Germany; (b) a face-to-face survey with parents of children taking the school entry-level health checkup; (c) a face-to-face survey of the physicians treating these children. Logistic, OLS and multilevel regressions were applied.
Results
Homophily due to similar ages of parents and physicians boosts the decision to vaccinate children against MMR. Also in relation to parent–physician interaction, the fact that a physician may be homeopathic has no effect on a parents’ decision to immunize, although vaccination-skeptical parents choose physicians who are trained in homeopathy.
Conclusions
Efforts to improve the number of parental decisions for vaccination should focus on the educational level of the parents as well as homophily of parents and physicians. Notably, homogeneity of parents and providers concerning age changes decisions in favor of vaccinating.
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References
Becker GS (1965) A theory of the allocation of time. Econ J 75(299):493–517
Becker GS (1995) Human capital. A theoretical and empirical analysis, with special reference to education, 3 ed. The University of Chicago Press, Chicago
Borràs E, Domínguez À, Fuentes M, Batalla J, Cardeñosa N, Plasencia A (2009) Parental knowledge of paediatric vaccination. BMC Public Health 9(154):1–7
Casiday RE (2007) Children’s health and the social theory of risk: insights from the British measles, mumps and rubella (MMR) controversy. Soc Sci Med 65:1059–1070
English JM (1995) The rights and wrongs of measles vaccination. Br Homoeopath J 84:156–163
Farrington CP, Kanaan MN, Gay NJ (2001) Estimation of the basic reproduction number for infectious diseases from age-stratified serological survey data. J R Stat Soc Ser C (Appl Stat) 50(3):251–292
Grossman M (2000) The human capital model. In: Culyer AJ, Newhouse JP (eds) Handbook of health economics. Elsevier, Amsterdam, pp 347–408
Gust DA, Strine TW, Maurice E, Smith PJ, Yusuf H, Wilkinson M, Battaglia MP, Wright R, Schwartz B (2004) Underimmunization among children: effects of vaccine safety concerns on immunization status. Pediatrics 114(1):16–22
Gust DA, Kennedy AM, Shui I, Smith PJ, Nowak G, Pickering LK (2005) Parent attitudes toward immunizations and healthcare providers. The role of information. Am J Prev Med 29(2):105–112
Hahné S, Te Wierik MJ, Mollema L, Velzen E, Coster E, Swaan C, Melker H, de Binnendijk R (2010) Measles outbreak, the Netherlands, 2008. Emerg Infect Dis J 16(3):567–569
Hethcote HW (2000) The mathematics of infectious diseases. SIAM Rev 42(4):599–653
Jansen VAA, Stollenwerk N, Jensen HJ, Ramsay ME, Edmunds WJ, Rhodes CJ (2003) Measles outbreaks in a population with declining vaccine uptake. Science 301(5634):804
Jones L, Sciamanna C, Lehman E (2010) Are those who use specific complementary and alternative medicine therapies less likely to be immunized? Prev Med 50:148–154
Keeling MJ, Grenfell BT (1997) Disease extinction and community size: modeling the persistence of measles. Science 275(5296):65–67
Kennedy AM, Gust DA (2008) Measles outbreak associated with a church congregation: a study of immunization attitudes of congregation members. Public Health Rep 123:126–134
Kennedy AM, Brown CJ, Gust DA (2005) Vaccine beliefs of parents who oppose compulsory vaccination. Public Health Rep 120:252–258
Lehrke P, Nuebling M, Hofmann F, Stoessel U (2001) Attitudes of homoeopathic physicians towards vaccination. Vaccine 19(32):4859–4864
Lieu TA, Black SB, Ray P, Schwalbe JA, Lewis EM, Lavetter A, Morozumi PA, Shinefield HR (1997) Computer-generated recall letters for underimmunized children: how cost-effective? Pediatr Infect Dis J 16(1):28–33
McPherson M, Smith-Lovin L, Cook JM (2001) Birds of a feather: homophily in social networks. Annu Rev Sociol 27:415–444
Meissner CH, Strebel PM, Orenstein WA (2004) Measles vaccines and the potential for worldwide eradication of measles. Pediatrics 114(4):1065–1069
Mikolajczyk RT, Akmatov MK, Stich H, Krämer A, Kretzschmar M (2008) Association between acculturation and childhood vaccination coverage in migrant populations: a population based study from a rural region in Bavaria, Germany. Int J Public Health 53(4):180–187
Neuhaus JM, Kalbfleisch JD, Hauck WW (1991) A comparison of cluster-specific and population-averaged approaches for analyzing correlated binary data. Int Stat Rev 59(1):25–35
Newswire (2011) Cardiff TELEform in strong demand by top European hospitals. http://www.prnewswire.co.uk/cgi/news/release?id=91530. Accessed 27 Apr 2011
Reiter S, Rasch G (2004) Schutzimpfungen, Heft 1, Gesundheitsberichterstattung des Bundes. RKI, Berlin
Richard JL, Masserey Spicher V (2009) Large measles epidemic in Switzerland from 2006 to 2009: consequences for the elimination of measles in Europe. Eurosurveill 14(50):19443
Robert Koch Institute (1999) Interventionsprogramm “Masern, mumps, Röteln (MMR)”. RKI, Berlin
Robert Koch Institute (2010) Impfquoten bei den Schuleingangsuntersuchungen in Deutschland 2008. Epidem Bull 16:137–140
Skea ZC, Entwistle VA, Watt I, Russell E (2008) Avoiding harm to others’ considerations in relation to parental measles, mumps and rubella (MMR) vaccination discussions—an analysis of an online chat forum. Soc Sci Med 67:1382–1390
Spence M (1973) Job market signaling. Q J Econ 87(3):355–374
Sporton RK, Francis SA (2001) Choosing not to immunize: are parents making informed choices? Fam Pract 18:181–188
Vandermeulen C, Roelants M, Theeten H, van Damme P, Hoppenbrouwers K (2008) Vaccination coverage and sociodemographic determinants of measles–mumps–rubella vaccination in three different age groups. Eur J Pediatr 167(10):1161–1168
Acknowledgments
The author is grateful to Monika Jungbauer-Gans and the German Research Foundation (DFG) for supporting the project. I thank Ralf Karhausen-Beermann and the Munich Ministry of Health and Environment for access to the school entry health checkup data, and Catherine Bennewitz, Kyle Hanniman and the two anonymous reviewers for helpful suggestions to improve the manuscript.
Conflict of interest
The author declares that he has no competing interests.
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Kriwy, P. Similarity of parents and physicians in the decision to vaccinate children against measles, mumps and rubella. Int J Public Health 57, 333–340 (2012). https://doi.org/10.1007/s00038-011-0326-9
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DOI: https://doi.org/10.1007/s00038-011-0326-9