Methods: We conducted two national internet panel surveys with discrete populations in 2012 (N=2603) and 2014 (N=2518) to assess parental vaccine decisions for the family’s youngest child (younger than 7 years old). From these surveys, we explored personal and household characteristics associated with reported pediatric immunization. We calculated survey-weighted population estimates and developed models of overall immunizations decisions as well as rates for delay or refusal of specific vaccines.
Results: Childcare arrangements are associated with pediatric vaccination decisions (χ2 = 52.0; df1 = 8; df2 = 41,330; p = 0.002). Among parents choosing vaccine delay or refusal, reasons for delay or refusal did not vary significantly based on childcare arrangement (delay: N=362, p=0.18; refusal: N=259, p=0.40). However, childcare arrangements were associated with reasons for immunization among parents accepting all vaccines (p=0.004), with daycare/school requirements specified as the primary reason for vaccinating by significantly more parents using daycare (9%; 95% CI: 6.6%-12.2%) than stay-at-home parents (4%: 3.2%-6.0%) (p=0.001), although overall refusal was rare in both groups.
Conclusion: Parents’ immunization decision-making is associated with childcare arrangements. Immunization policies at daycare and school facilities may be a factor in a parents’ decision to vaccinate their children, especially for parents who may be hesitant about immunizing their child. Stay-at-home parents of young children may be less inclined to follow immunization schedules, as they are not bound by school immunization policies; they may also perceive limited transmission potential as their child is not exposed to other children. Therefore, it may be even more important for these parents to maintain a strong relationship with their child’s provider as childcare requirements may not be a top factor in their decision to vaccinate their child.
A. Fisher, None
M. Basket, None
J. Mullen, None
Y. Chung, None
L. Flannigan, None
J. Weiner, None