title: Negative attitude of highly educated parents and health care workers towards future vaccinations in the Dutch childhood vaccination program.
abstract: BACKGROUND
  It is unknown whether further expansion of the Dutch childhood vaccination program with other vaccines will be accepted and whom should be targeted in educational strategies.
  
  
  OBJECTIVE
  To determine attitudes of parents towards possible future vaccinations for their children and the behavioural determinants associated with a negative attitude.
  
  
  METHODS
  Questionnaire study.
  
  
  METHODS
  Parents of children aged between 3 months and 5 years of day-care centres were asked to fill out a questionnaire. Determinants of a negative attitude to comply with possible future vaccinations against example diseases such as pneumonia or influenza, hepatitis B, TBC, smallpox and SARS were assessed using polytomous logistic regression analysis.
  
  
  RESULTS
  Of the 283 respondents, 123 (43%) reported a positive attitude towards all vaccinations, 129 (46%) reported to have a positive attitude to have their child vaccinated against some diseases and 31 (11%) had no intention to comply with any new vaccination. Determinants of a fully negative attitude were a high education of the parent (odds ratio [OR] 3.3, 95% confidence interval [95% CI]: 1.3-8.6), being a health care worker (OR 4.2, 95% CI: 1.4-12.6), absence of religion (OR 2.6, 95% CI: 1.0-6.7), perception of vaccine ineffectiveness (OR 6.9, 95% CI: 2.5-18.9) and the perception that vaccinations cause asthma or allergies (OR 82.4, 95% CI: 8.9-766.8).
  
  
  CONCLUSIONS
  Modifiable determinants for a negative attitude to comply with new vaccinations are mainly based on lack of specific knowledge. These barriers to vaccinations might be overcome by improving health education in the vaccination program, especially when targeted at educated parents and health care workers.
authors.affiliation: University Medical Center Utrecht, Julius Center for Health Sciences and Primary Health Care, HP Str. 6.131, P.O. Box 85060, 3508 AB Utrecht, The Netherlands. e.hak@umcutrecht.nl
authors.forename: E
authors.initials: E
authors.lastname: Hak
authors.forename: Y
authors.initials: Y
authors.lastname: Schönbeck
authors.forename: H
authors.initials: H
authors.lastname: De Melker
authors.forename: G A
authors.initials: GA
authors.lastname: Van Essen
authors.forename: E A M
authors.initials: EA
authors.lastname: Sanders
mesh_terms: D000328:Adult; D001290:Attitude; D001291:Attitude of Health Personnel; D002675:Child, Preschool; D003625:Data Collection; D004493:Education; D005260:Female; D017144:Focus Groups; D006801:Humans; D007223:Infant; D008297:Male; D032541:Mass Vaccination / Q000009:adverse effects; D009426:Netherlands; D010290:Parents; D010349:Patient Compliance; D012737:Sex Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires