title: Factors that influence vaccination decision-making by parents who visit an anthroposophical child welfare center: a focus group study.
abstract: In recent years, parents have become more disparaging towards childhood vaccination. One group that is critical about the National Immunization Program (NIP) and participates less comprises parents with an anthroposophical worldview. Despite the fact that various studies have identified anthroposophists as critical parents with lower vaccination coverage, no research has been done to explore the beliefs underlying their childhood vaccination decision-making. We conducted a qualitative study using three focus groups (n = 16) of parents who visit an anthroposophical child welfare center. Our findings show that participants did not refuse all vaccinations within the Dutch NIP, but mostly refused the Mumps, Measles, and Rubella (MMR) vaccination. Vaccination decisions are influenced by participants' lifestyle, perception of health, beliefs about childhood diseases, perceptions about the risks of diseases, perceptions about vaccine effectiveness and vaccine components, and trust in institutions. Parents indicated that they felt a need for more information. Sufficient references should be provided to sources containing more information about childhood vaccination, especially about the effectiveness of vaccines and vaccine components and the risks, such as possible side effects and benefits of vaccination. This may satisfy parents' information needs and enable them to make a sufficiently informed choice whether or not to vaccinate their child.
authors.affiliation: Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, The Netherlands ; Department of Work and Social Psychology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
authors.forename: Irene A
authors.initials: IA
authors.lastname: Harmsen
authors.forename: Robert A C
authors.initials: RA
authors.lastname: Ruiter
authors.forename: Theo G W
authors.initials: TG
authors.lastname: Paulussen
authors.forename: Liesbeth
authors.initials: L
authors.lastname: Mollema
authors.forename: Gerjo
authors.initials: G
authors.lastname: Kok
authors.forename: Hester E
authors.initials: HE
authors.lastname: de Melker