1640. Childcare Situations and Parental Immunization Decisions for Young Children
Session: Poster Abstract Session: Vaccine Hesitancy
Friday, October 6, 2017
Room: Poster Hall CD
Background: Vaccine-preventable disease (VPD) outbreaks in school and childcare settings have been linked to lack of strong school vaccination requirements. We examined the role of childcare arrangements as a factor in parents’ decision- making about their child’s immunizations.

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.

Paula Frew, PhD, MA, MPH1,2,3,4, Jay Schamel, BS5, Alison Fisher, MPH6, Michelle Basket, BS7, Jennifer Mullen, MPH7, Yunmi Chung, MPH8, Lillian Flannigan, MPH9 and Judith Weiner, PhD10, (1)Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, (2)Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, (3)Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory Univeristy, Atlanta, GA, (4)National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, (5)Oak Ridge Institute for Science and Education (ORISE) - CDC, Atlanta, GA, (6)Centers for Disease Control and Prevention, Atlanta, GA, (7)CDC, 1600 Clifton Rd NE, GA, (8)Oak Ridge Institute for Science and Education (ORISE) - CDC, 1600 Clifton Rd NE, GA, (9)Medicine, Emory University School of Medicine, Atlanta, GA, (10)Northrop Grumman, 1600 Clifton Rd NE, GA


P. Frew, None

J. Schamel, None

A. Fisher, None

M. Basket, None

J. Mullen, None

Y. Chung, None

L. Flannigan, None

J. Weiner, None

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