Skip to main content

Advertisement

SpringerLink
Log in

Postpartum Mothers’ Attitudes, Knowledge, and Trust Regarding Vaccination

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

Objective To examine attitudes and knowledge about vaccinations in postpartum mothers. Methods This cross-sectional study collected data via written survey to postpartum mothers in a large teaching hospital in Connecticut. We used multivariable analysis to identify mothers who were less trusting with regard to vaccines. Results Of 228 mothers who participated in the study, 29% of mothers worried about vaccinating their infants: 23% were worried the vaccines would not work, 11% were worried the doctor would give the wrong vaccine, and 8% worried that “they” are experimenting when they give vaccines. Mothers reported that the most important reasons to vaccinate were to prevent disease in the baby (74%) and in society (11%). Knowledge about vaccination was poor; e.g., 33% correctly matched chicken pox with varicella vaccine. Mothers who were planning to breastfeed (P = .01), were primiparous (P = .01), or had an income <$40,000 but did not receive support from the women, infants, and children (WIC) program were less trusting with regard to vaccines (P = .03). Although 70% wanted information about vaccines during pregnancy, only 18% reported receiving such information during prenatal care. Conclusion Although the majority of infants receive vaccines, their mothers have concerns and would like to receive immunization information earlier. Mothers who are primiparous, have low family incomes but do not qualify for the WIC program, or are breastfeeding may need special attention to develop a trusting relationship around vaccination. Mothers would benefit from additional knowledge regarding the risks and benefits of vaccines particularly during prenatal care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Smailbegovic, M. S., Laing, G. J., & Bedford, H. (2003). Why do parents decide against immunization? The effect of health beliefs and health professionals. Child Care Health Development, 29(4), 303–311.

    Article  CAS  Google Scholar 

  2. Allred, N. J., Shaw, K. M., Santibanez, T. A., Rickert, D. L., & Santoli, J. M. (2005). Parental vaccine safety concerns: Results from the National Immunization Survey, 2001–2002. American Journal of Prevention Medicine, 28(2), 221–224.

    Article  Google Scholar 

  3. Freed, G. L., Clark, S. J., Hibbs, B. F., & Santoli, J. M. (2004). Parental vaccine safety concerns. The experiences of pediatricians and family physicians. American Journal of Prevention Medicine, 26(1), 11–14.

    Article  Google Scholar 

  4. Benin, A. L., Colson, E., Shapiro, E. D., & Holmboe, E. (2006). Qualitative analysis of mothers’ decision-making about vaccines for infants: The importance of trust. Pediatrics, 117, 1532–1541.

    Article  PubMed  Google Scholar 

  5. McPhillips, H. A., Davis, R. L., Marcuse, E. K., & Taylor, J. A. (2001). The rotavirus vaccine’s withdrawal and physicians’ trust in vaccine safety mechanisms. Archives Pediatric and Adolescent Medicine, 155(9), 1051–1056.

    CAS  Google Scholar 

  6. From the Centers for Disease Control and Prevention (1999). Recommendations regarding the use of vaccines that contain thimerosal as a preservative. JAMA, 282(22), 2114–2115.

    Article  Google Scholar 

  7. Taylor, B., Miller, E., Farrington, C. P., et al. (1999). Autism and measles, mumps, and rubella vaccine: No epidemiological evidence for a causal association. Lancet, 353(9169), 2026–2029.

    Article  PubMed  CAS  Google Scholar 

  8. Durbach, N. (2000). ‘They might as well brand us’: Working-class resistance to compulsory vaccination in Victorian England. Social History of Medicine, 13(1), 45–62.

    Article  PubMed  CAS  Google Scholar 

  9. Nasir, L. (2002). Antivaccination web sites. JAMA, 288(14), 1718; author reply.

    Article  PubMed  Google Scholar 

  10. Nasir, L. (2000). Reconnoitering the antivaccination web sites: News from the front. Journal of Family Practice, 49(8), 731–733.

    PubMed  CAS  Google Scholar 

  11. Feikin, D. R., Lezotte, D. C., Hamman, R. F., Salmon, D. A., Chen, R. T., & Hoffman, R. E. (2000). Individual and community risks of measles and pertussis associated with personal exemptions to immunization. JAMA, 284(24), 3145–3150.

    Article  PubMed  CAS  Google Scholar 

  12. Gangarosa, E. J., Galazka, A. M., Wolfe, C. R., et al. (1998). Impact of anti-vaccine movements on pertussis control: The untold story. Lancet, 351(9099), 356–361.

    Article  PubMed  CAS  Google Scholar 

  13. Salmon, D. A., Haber, M., Gangarosa, E. J., Phillips, L., Smith, N. J., & Chen, R. T. (1999). Health consequences of religious and philosophical exemptions from immunization laws: Individual and societal risk of measles. JAMA, 282(1), 47–53.

    Article  PubMed  CAS  Google Scholar 

  14. Rodgers, D. V., Gindler, J. S., Atkinson, W. L., & Markowitz, L. E. (1993). High attack rates and case fatality during a measles outbreak in groups with religious exemption to vaccination. Pediatric Infectious Disease Journal, 12(4), 288–292.

    Article  PubMed  CAS  Google Scholar 

  15. Fredrickson, D. D., Davis, T. C., Arnould, C. L., et al. (2004). Childhood immunization refusal: Provider and parent perceptions. Family Medicine, 36(6), 431–439.

    PubMed  Google Scholar 

  16. Gust, D. A., Strine, T. W., Maurice, E., et al. (2004). Underimmunization among children: Effects of vaccine safety concerns on immunization status. Pediatrics, 114(1), e16–e22.

    Article  PubMed  Google Scholar 

  17. Gellin, B. G., Maibach, E. W., & Marcuse, E. K. (2000). Do parents understand immunizations? A national telephone survey. Pediatrics, 106(5), 1097–1102.

    Article  PubMed  CAS  Google Scholar 

  18. CDC (2005). National, state, and urban area vaccination coverage among children aged 19–35 months—United States, 2004. MMWR, 54(29), 717–721. (Accessed September 27, 2007, at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5429a1.htm).

  19. Taylor, J. A., Darden, P. M., Slora, E., Hasemeier, C. M., Asmussen, L., & Wasserman, R. (1997). The influence of provider behavior, parental characteristics, and a public policy initiative on the immunization status of children followed by private pediatricians: A study from Pediatric Research in Office Settings. Pediatrics, 99(2), 209–215.

    PubMed  CAS  Google Scholar 

  20. Szilagyi, P. G., Rodewald, L. E., Humiston, S. G., et al. (1994). Immunization practices of pediatricians and family physicians in the United States. Pediatrics, 94(4 Pt 1), 517–523.

    PubMed  CAS  Google Scholar 

  21. Koepke, C. P., Vogel, C. A., & Kohrt, A. E. (2001). Provider characteristics and behaviors as predictors of immunization coverage. American Journal of Prevention Medicine, 21(4), 250–255.

    Article  CAS  Google Scholar 

  22. Rodewald, L. E., Szilagyi, P. G., Shiuh, T., Humiston, S. G., LeBaron, C., & Hall, C. B. (1995). Is underimmunization a marker for insufficient utilization of preventive and primary care? Archives of Pediatrics and Adolescent Medicine, 149(4), 393–397.

    PubMed  CAS  Google Scholar 

  23. LeBaron, C. W., Rodewald, L., & Humiston, S. (1999). How much time is spent on well-child care and vaccinations? Archives of Pediatrics and Adolescent Medicine, 153(11), 1154–1159.

    PubMed  CAS  Google Scholar 

  24. Gust, D. A., Kennedy, A., Shui, I., Smith, P. J., Nowak, G., & Pickering, L. K. (2005). Parent attitudes toward immunizations and healthcare providers the role of information. American Journal of Prevention Medicine, 29(2), 105–112.

    Article  Google Scholar 

  25. 2006 Childhood & Adolescent Immunization Schedule. 2006. (Accessed December 5, 2006, at http://www.cdc.gov/nip/recs/child-schedule.htm#Printable).

  26. Halbreich, U. (2005). Postpartum disorders: Multiple interacting underlying mechanisms and risk factors. Journal of Affective Disorders, 88(1), 1–7.

    Article  PubMed  Google Scholar 

  27. Benin A. L., Colson, E., Shapiro, E. D., & Holmboe, E. (2006). Qualitative analysis of mothers’ decision-making about vaccines for infants: The importance of trust. Pediatrics, 117(5), 1532–1541.

    Article  PubMed  Google Scholar 

  28. Barker, L. E., Chu, S. Y., Li, Q., Shaw, K. M., & Santoli, J. M. (2006). Disparities between white and African-American children in immunization coverage. Journal National of Medical Association, 98(2), 130–135.

    Google Scholar 

  29. Klevens, R. M., & Luman, E. T. (2001). U.S. children living in and near poverty: Risk of vaccine-preventable diseases. American Journal of Prevention Medicine, 20(4 Suppl), 41–46.

    Article  CAS  Google Scholar 

  30. Brenner, R. A., Simons-Morton, B. G., Bhaskar, B., Das, A., & Clemens, J. D. (2001). Prevalence and predictors of immunization among inner-city infants: A birth cohort study. Pediatrics, 108(3), 661–670.

    Article  PubMed  CAS  Google Scholar 

  31. Samad, L., Tate, A. R., Dezateux, C., Peckham, C., Butler, N., & Bedford, H. (2006). Differences in risk factors for partial and no immunisation in the first year of life: Prospective cohort study. BMJ, 332(7553), 1312–1313.

    Article  PubMed  Google Scholar 

  32. Schaffer, S. J., & Szilagyi, P. G. (1995). Immunization status and birth order. Archives of Pediatrics and Adolescent Medicine, 149(7), 792–797.

    PubMed  CAS  Google Scholar 

  33. Shui, I., Kennedy, A., Wooten, K., Schwartz, B., & Gust, D. (2005). Factors influencing African-American mothers’ concerns about immunization safety: A summary of focus group findings. Journal of National Medical Association, 97(5), 657–666.

    Google Scholar 

  34. Smith, P. J., Kennedy, A. M., Wooten, K., Gust, D. A., & Pickering, L. K. (2006). Association between health care providers’ influence on parents who have concerns about vaccine safety and vaccination coverage. Pediatrics, 118(5), e1287–e1292.

    Article  PubMed  Google Scholar 

  35. Gnanasekaran, S. K., Finkelstein, J. A., Hohman, K., O’Brien M, Kruskal, B., & Lieu, T. (2006). Parental perspectives on influenza vaccination among children with asthma. Public Health Representation, 121(2), 181–188.

    Google Scholar 

  36. Keane, M. T., Walter, M. V., Patel, B. I., et al. (2005). Confidence in vaccination: A parent model. Vaccine, 23(19), 2486–2493.

    Article  PubMed  Google Scholar 

  37. Salmon, D. A., Moulton, L. H., Omer, S. B., DeHart, M. P., Stokley, S., & Halsey, N. A. (2005). Factors associated with refusal of childhood vaccines among parents of school-aged children: A case–control study. Archives of Pediatric and Adolescent Medicien, 159(5), 470–476.

    Article  Google Scholar 

  38. Halsam, C., Lawrence, W., & Haefeli, K. (2003). Intention to breastfeed and other important health-related behavior and beliefs during pregnancy. Family Practice, 20(5), 528–530.

    Article  Google Scholar 

  39. Moseley, K. L., Clark, S. J., Gebremariam, A., et al. (2006). Parents’ trust in their child’s physician: Using an adapted trust in physician scale. Ambulatory Pediatrics, 5(1), 58–61.

    Article  Google Scholar 

  40. Gregory, K. D., Johnson, C. T., Johnson, T. R., & Entman, S. S. (2006). The content of prenatal care. Update 2005. Womens Health Issues, 16(4), 198–215.

    Article  PubMed  Google Scholar 

  41. Serwint, J. R., Wilson, M. E., Vogelhut, J. W., Repke, J. T., & Seidel, H. M. (1996). A randomized controlled trial of prenatal pediatric visits for urban, low-income families. Pediatrics, 98(6 Pt 1), 1069–1075.

    PubMed  CAS  Google Scholar 

  42. Shui, I. M., Weintraub, E. S., & Gust, D. A. (2006). Parents concerned about vaccine safety: Differences in race/ethnicity and attitudes. American Journal of Prevention Medicne, 31(3), 244–251.

    Article  Google Scholar 

Download references

Acknowledgments

We would like to thank the mothers who spent their precious postpartum time helping us with this survey. This work was supported in part by a grants from the National Institutes of Health (K24-AI01703, T32-AI07210-23), by the Yale General Clinical Research Centers Program of the National Center for Research Resources, NIH (M01-RR06022), and by the Robert Wood Johnson Clinical Scholars Program.

Author information

Authors and Affiliations

  1. Department of Ambulatory Care and Prevention, Harvard Medical School, and Children’s Hospital, 133 Brookline Avenue, 6th Floor, Boston, MA, 02215-5301, USA

    Ann Chen Wu

  2. Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA

    Daryl J. Wisler-Sher, Eve Colson, Eugene D. Shapiro & Andrea L. Benin

  3. Department of Pediatrics, Columbia University School of Medicine, New York, NY, USA

    Daryl J. Wisler-Sher

  4. Northwestern University School of Medicine, Chicago, IL, USA

    Katherine Griswold

  5. Department of Epidemiology and Public Health and the General Clinical Research Center, Yale University School of Medicine, New Haven, CT, USA

    Eugene D. Shapiro

  6. The American Board of Internal Medicine, Philadelphia, PA, USA

    Eric S. Holmboe

  7. Robert Wood Johnson Clinical Scholars Program, Yale University School of Medicine, New Haven, CT, USA

    Eric S. Holmboe & Andrea L. Benin

Authors
  1. Ann Chen Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Daryl J. Wisler-Sher
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Katherine Griswold
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Eve Colson
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Eugene D. Shapiro
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Eric S. Holmboe
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Andrea L. Benin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ann Chen Wu.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wu, A.C., Wisler-Sher, D.J., Griswold, K. et al. Postpartum Mothers’ Attitudes, Knowledge, and Trust Regarding Vaccination. Matern Child Health J 12, 766–773 (2008). https://doi.org/10.1007/s10995-007-0302-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-007-0302-4

Keywords

Search

Navigation