title: Association of vaccine-related attitudes and beliefs between parents and health care providers.
abstract: Health care providers influence parental vaccination decisions. Over 90% of parents report receiving vaccine information from their child's health care provider. The majority of parents of vaccinated children and children exempt from school immunization requirements report their child's primary provider is a good source for vaccine information. The role of health care providers in influencing parents who refuse vaccines has not been fully explored. The objective of the study was to determine the association between vaccine-related attitudes and beliefs of health care providers and parents.
  
  
  
  We surveyed parents and primary care providers of vaccinated and unvaccinated school age children in four states in 2002-2003 and 2005. We measured key immunization beliefs including perceived risks and benefits of vaccination. Odds ratios for associations between parental and provider responses were calculated using logistic regression.
  
  
  
  Surveys were completed by 1367 parents (56.1% response rate) and 551 providers (84.3% response rate). Parents with high confidence in vaccine safety were more likely to have providers with similar beliefs, however viewpoints regarding disease susceptibility and severity and vaccine efficacy were not associated. Parents whose providers believed that children get more immunizations than are good for them had 4.6 higher odds of holding that same belief compared to parents whose providers did not have that belief.
  
  
  
  The beliefs of children's health care providers and parents, including those regarding vaccine safety, are similar. Provider beliefs may contribute to parental decisions to accept, delay or forgo vaccinations. Parents may selectively choose providers who have similar beliefs to their own.
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. Electronic address: mergler@jhu.edu.
authors.forename: Michelle
authors.initials: M
authors.lastname: Mergler Hughes
authors.forename: Saad B
authors.initials: SB
authors.lastname: Omer
authors.forename: William K Y
authors.initials: WK
authors.lastname: Pan
authors.forename: Ann Marie
authors.initials: AM
authors.lastname: Navar-Boggan
authors.forename: Walter
authors.initials: W
authors.lastname: Orenstein
authors.forename: Edgar K
authors.initials: EK
authors.lastname: Marcuse
authors.forename: James
authors.initials: J
authors.lastname: Taylor
authors.forename: M Patricia
authors.initials: MP
authors.lastname: DeHart
authors.forename: Terrell C
authors.initials: TC
authors.lastname: Carter
authors.forename: Anthony
authors.initials: A
authors.lastname: Damico
authors.forename: Neal
authors.initials: N
authors.lastname: Halsey
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Salmon
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006801:Humans; D008297:Male; D010290:Parents; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D014611:Vaccination / Q000523:psychology*; D014612:Vaccines / Q000008:administration & dosage* / Q000009:adverse effects*
chemical_list: D014612:Vaccines
keywords: Health care surveys; Health personnel/education; Questionnaires; Vaccination/psychology; Vaccines/adverse effects