635. Parental Vaccine Hesitancy and Refusal: Perceptions of Midwestern Members of the American Academy of Pediatric
Session: Poster Abstract Session: Pediatric Vaccines
Friday, October 21, 2011
Room: Poster Hall B1
Background: For most patients, vaccines are safe and effective, yet there are ~85,000 cases/year of vaccine-preventable disease. Vaccine hesitancy has not been a high-profile issue in the midwest. Our objective was to explore midwestern American Academy of Pediatrics (AAP) members’ perspectives on parental vaccine hesitancy/refusal.

Methods: With cooperation from the state chapters of 9 midwestern states in District VI of the American Academy of Pediatrics, participants were recruited via email and prompted to complete an on-line survey. We used a weighted rank to score ordinal responses. The protocol was given exempt status by Children’s Mercy Hospital’s IRB.

Results: There were 909 responders. Demographics were available for 772:  88 % White, 6% Asian, 2% Black and 4% other; 3 % self-identified as Hispanic/Latino; 58 % female; 59% fell within the 35-54 age range.  Complete or near-complete responses were available for 695 participants. Overall the 3 vaccines that parents most often refuse or defer per responder reports were: 1. MMR, 2. HPV and 3. influenza. The most frequent reasons given were fear of autism, too many shots, and serious side effects. Engaging family in discussion/ presenting options was the number 1 intervention reported across all states at 95%. 66% of responders referred families to websites and 63% used evidenced-based literature.  Only 1% of responders reported using no intervention with hesitant/refusing families.  Practitioners reported seeing anywhere from 1% to greater than 50% of parents delaying or altering the recommended vaccine schedule, and 0% up to 40% of parents refusing at least some vaccines. The majority in all states still report < 5% overall vaccine refusal and < 20% vaccine schedule alteration, although some individuals report much higher rates. Overall, 21% of practitioners reported discharging families from their practice for continued refusal of all vaccines, with Minnesota lowest at 0.9% and Iowa highest at 38%.

Conclusion: Midwest providers have variable attitudes and experience with vaccine hesitancy/refusal. The insights gained from this pilot survey will help design a more definitive survey as well as assist in the design of educational or interventional strategies for practitioners.

Subject Category: J. Clinical practice issues

Thomas Tryon1,2, Nancy Neilan1, Jacqueline Bartlett1 and Christopher Harrison2,3, (1)Children's Mercy Hospitals and Clinics, Kansas City, MO, (2)UMKC Sch of Medicine, Kansas City, MO, (3)Children's Mercy Hospital and Clinics, Kansas City, MO


T. Tryon, None

N. Neilan, None

J. Bartlett, None

C. Harrison, GlaxoSmithKline: Investigator, Research grant

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