Maternal and Child Health Journal

, Volume 21, Issue 12, pp 2178–2187 | Cite as

Influences on Immunization Decision-Making among US Parents of Young Children

  • Yunmi ChungEmail author
  • Jay Schamel
  • Allison Fisher
  • Paula M. Frew


Objectives This study assessed influences on vaccination decisions among parents of young children and examined common vaccination information and advice sources. Methods Using panel samples of parents of children under 7 years, web-based surveys were conducted in 2012 (n = 2603) and 2014 (n = 2518). A vaccine decision-making typology (non-hesitant acceptors, hesitant acceptors, delayers, and refusers) was established and weighted population estimates of potential factors influencing parental vaccination decision (e.g., provider influence, source of information and advice) were computed by year and decision type. Results Delayers and refusers were more likely than acceptors to know someone whose child experienced a severe reaction to a vaccine or delayed/refused vaccine(s). High proportions of delayers (2012: 33.4%, 2014: 33.9%) and refusers (2012: 49.6%, 2014: 58.6%) reported selecting their healthcare provider based on whether the provider would allow them to delay/refuse vaccines. Providers were the most frequently reported trusted vaccine information source among all parents, though more often by acceptors than refusers (2012, 2014: p < 0.01). We found differing patterns of provider advice-seeking and internet as a reliable vaccine information source by group. Among those who had considered delay/refusal, trust in their healthcare provider’s advice was the most common reason cited for their decision reversal. Conclusions for Practice Provider trust and communication along with varying degrees of personal-network influences likely contribute to immunization decisions of parents. Vaccine hesitant parents often seek providers amenable to accommodating their vaccine beliefs. Providers may benefit from vaccine communication training as their recommendations may influence hesitant parents to immunize their children.


Vaccine acceptability Vaccine delay Vaccine hesitancy Vaccine refusal Pediatric populations Parental decision-making 



The authors would like to acknowledge all the poll participants of this study. This research was supported in part by a grant from the Centers for Disease Control and Prevention (CDC) and an appointment to the Research Participation Program at the CDC administered by the Oak Ridge Institute for Science and Education through an interagency agreement between the U.S. Department of Energy and CDC. The findings and conclusions in this report are those of the authors, and do not necessarily represent the official position of the Centers for Disease Control and Prevention.


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Copyright information

© Springer Science+Business Media, LLC (outside the USA) 2017

Authors and Affiliations

  1. 1.Division of Infectious Diseases, Department of MedicineEmory University School of MedicineAtlantaUSA
  2. 2.Oak Ridge Institue for Science and Education (ORISE)Oak RidgeUSA
  3. 3.National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and PreventionAtlantaUSA
  4. 4.Department of Behavioral Sciences and Health Education, Rollins School of Public HealthEmory UniversityAtlantaUSA
  5. 5.Hubert Department of Global Health, Rollins School of Public HealthEmory UniversityAtlantaUSA
  6. 6.Institute of Public and Preventive HealthAugusta UniversityAugustaUSA

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