Factors underlying parental decisions about combination childhood vaccinations including MMR: a systematic review.
Suboptimal childhood vaccination uptake results in disease outbreaks, and in developed countries is largely attributable to parental choice. To inform evidence-based interventions, we conducted a systematic review of factors underlying parental vaccination decisions. Thirty-one studies were reviewed. Outcomes and methods are disparate, which limits synthesis; however parents are consistently shown to act in line with their attitudes to combination childhood vaccinations. Vaccine-declining parents believe that vaccines are unsafe and ineffective and that the diseases they are given to prevent are mild and uncommon; they mistrust their health professionals, Government and officially-endorsed vaccine research but trust media and non-official information sources and resent perceived pressure to risk their own child's safety for public health benefit. Interventions should focus on detailed decision mechanisms including disease-related anticipated regret and perception of anecdotal information as statistically representative. Self-reported vaccine uptake, retrospective attitude assessment and unrepresentative samples limit the reliability of reviewed data - methodological improvements are required in this area.
Brown
Katrina F
KF
Centre for Patient Safety and Service Quality, Imperial College London, St. Mary's Hospital Campus, London W2 1NY, United Kingdom. Katrina.Brown@imperial.ac.uk
Kroll
J Simon
JS
Hudson
Michael J
MJ
Ramsay
Mary
M
Green
John
J
Long
Susannah J
SJ
Vincent
Charles A
CA
Fraser
Graham
G
Sevdalis
Nick
N
D002675:Child, Preschool; D002755:Choice Behavior; D003657:Decision Making; D019049:Developed Countries; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage; D010290:Parents / Q000523:psychology*; D014611:Vaccination / Q000523:psychology*; D017778:Vaccines, Combined / Q000008:administration & dosage
D022542:Measles-Mumps-Rubella Vaccine; D017778:Vaccines, Combined