title: Are parental vaccine safety concerns associated with receipt of measles-mumps-rubella, diphtheria and tetanus toxoids with acellular pertussis, or hepatitis B vaccines by children?
abstract: OBJECTIVE
  To identify parental perceptions regarding vaccine safety and assess their relationship with the immunization status of children.
  
  
  METHODS
  Case-control study based on a survey of a sample of households participating in the 2000-2001 National Immunization Survey, a quarterly random-digit-dialing sample of US children aged 19 to 35 months. Three groups of case children not up-to-date for 3 vaccines were compared with control children who were up-to-date for each respective vaccine. Main Outcome Measure Measles-containing or measles-mumps-rubella, diphtheria and tetanus toxoids and pertussis or diphtheria and tetanus toxoids with acellular pertussis, and hepatitis B vaccination coverage.
  
  
  RESULTS
  Among those sampled from the 2000-2001 National Immunization Survey, the household response rate was 2315 (52.1%) of 4440. Most respondents (>90%) in all groups believed vaccinations are important. In each case-control group, there was no significant difference between the percentage of case and control parents expressing general vaccine safety (range, 53.5%-64.1%). However, case parents were more likely to have asked that their child not be vaccinated for reasons other than illness (range, 10.2%-13.7% vs range, 2.9%-5.3%, respectively) and to believe their children received too many vaccinations (range, 3.4%-7.6% vs range, 0.8%-1.0%, respectively). Among the case-control group receiving a measles-containing or measles-mumps-rubella vaccination, only a small percentage of parents knew about the alleged association between autism and measles-mumps-rubella vaccinations (8.2%), and case parents were more likely to believe it than control parents (4.4% vs 1.5%, respectively; chi(2) P =.04).
  
  
  CONCLUSIONS
  Despite belief in the importance of immunization by a vast majority of parents, the majority of parents had concerns regarding vaccine safety. Strategies to address important misperceptions about vaccine safety as well as additional research assessing vaccine safety are needed to ensure public confidence.
authors.affiliation: Division of Immunization Services, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. BFB7@cdc.gov
authors.forename: Barbara
authors.initials: B
authors.lastname: Bardenheier
authors.forename: Hussain
authors.initials: H
authors.lastname: Yusuf
authors.forename: Benjamin
authors.initials: B
authors.lastname: Schwartz
authors.forename: Deborah
authors.initials: D
authors.lastname: Gust
authors.forename: Lawrence
authors.initials: L
authors.lastname: Barker
authors.forename: Lance
authors.initials: L
authors.lastname: Rodewald
mesh_terms: D000328:Adult; D017677:Age Distribution; D016022:Case-Control Studies; D002675:Child, Preschool; D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines / Q000627:therapeutic use*; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D017325:Hepatitis B Vaccines / Q000627:therapeutic use*; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data*; D007223:Infant; D008297:Male; D022542:Measles-Mumps-Rubella Vaccine / Q000627:therapeutic use*; D010290:Parents; D012959:Socioeconomic Factors; D016312:Treatment Refusal / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology
chemical_list: D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines; D017325:Hepatitis B Vaccines; D022542:Measles-Mumps-Rubella Vaccine