title: Immune overload: Parental attitudes toward combination and single antigen vaccines.
abstract: Parental concerns have led to a recent decline in immunization coverage, resulting in outbreaks of diseases that were once under control in the US. As the CDC vaccination schedule continues to increase in complexity, the number of required injections per office visit increases as well. Some parents perceive that there is trauma associated with the administration of multiple injections, and research shows that having multiple vaccines due in a single visit is associated with delays and lower immunization rates. Combination vaccines make vaccination more efficient by incorporating the antigens of several different diseases into a single injection, but many parents worry that they may overload the child's developing immune system and leave him or her susceptible to secondary infections. This literature review synthesizes current evidence regarding the parental fear of vaccine-induced immune system overload and the fear of vaccine-associated trauma, in an attempt to understand the scope and nature of these fears. Despite the wealth of knowledge about each of these fears individually, it is still unknown which is of greater concern and how this affects parental decision-making.
authors.affiliation: University of Tennessee, Knoxville College of Nursing, United States. Electronic address: ehulsey@vols.utk.edu.
authors.forename: Ella
authors.initials: E
authors.lastname: Hulsey
authors.affiliation: University of Tennessee, Knoxville College of Nursing, United States.
authors.forename: Tami
authors.initials: T
authors.lastname: Bland
mesh_terms: D002648:Child; D003657:Decision Making; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007115:Immunization Schedule; D008297:Male; D010290:Parents / Q000523:psychology*; D014611:Vaccination / Q000523:psychology / Q000706:statistics & numerical data; D014612:Vaccines / Q000008:administration & dosage*; D017778:Vaccines, Combined / Q000008:administration & dosage*
chemical_list: D014612:Vaccines; D017778:Vaccines, Combined
keywords: Alternative vaccine schedule; Combination vaccine; Immune overload; Parental attitude; Single antigen vaccine; Vaccine refusal