Maternal perceptions of childhood vaccination: reasons for and against

Transcription

1 Maternal perceptions of childhood vaccination: reasons for and against By: Melissa Mueller Student BA Honours Psychology BA Communications Studies University of Calgary

2 Disclosure Statement I have no affiliation (financial or otherwise) with a pharmaceutical, medical device or communications organization.

3 Background Vaccination reduces communicable disease. 1 Yet, vaccination rates are still below targets in Canada. 2 Why? Parental vaccination decision making involves cognitive, psychosocial, and political factors influenced by current scientific, cultural, and media environments. 3 Complete refusal Confident acceptance 4

4 Objective & Research Question To better understand maternal vaccination decision making for infants up to 24 months of age. How do mothers explain their decisions to vaccinate, not vaccinate, or not fully vaccinate their children?

5 Method Data was from All Our Babies (AOB) cohort An ongoing longitudinal pregnancy cohort study in Calgary, Alberta Questionnaires were mailed to participants twice in pregnancy and at 4, 12, and 24 months after birth 24 month questionnaire asked: If your child has NOT received any or all of the vaccinations listed above, for what reason(s) did you NOT immunize your child? If your child has received any or all of the vaccinations listed above, for what reason(s) did you immunize your child?

6 Thematic analysis Method 1560 open-ended responses Codes categories sub-themes themes Responses linked to actual vaccination status Via child personal health numbers (PHN)

7 Results: themes Responsibility Choice Risk Risk Effectiveness Balancing Risks and Benefits Research Balancing Risks and Benefits Instrumental/Practical Effectiveness Health Issues Research

8 Context Results Why Vaccinate Why Not Vaccinate/Delay Motivation Motivation Intrinsically Intrinsically Extrinsically Extrinsically Level of Conviction Level of Conviction Conviction Conviction Lack of Conviction Lack of Conviction

9 Influencers Why Vaccinate Experience Results Personal/family External Influences Trust Pressured Opportunity Social Norm Why Not Vaccinate/Delay Experience Family/Friend/Personal External Influences Lack of Trust Pressured Consulted with Health Professional

10 Results Risk Responsibility Effectiveness Balancing Risks and Benefits Research Reasons Risk Necessary Protection/Prevention/ Precaution Travel Healthier with them Safety Research It s Smart Effectiveness Effective Balancing Risks and Benefits Benefits Outweigh the Risks Responsibility Personal Social Altruism

11 Choice Risk Balancing Risks and Benefits Instrumental/Practical Research Effectiveness Health Issues Results Reasons Risk Unnecessary Research Autism Allergy Issues Effectiveness Concern with Effectiveness Balancing Risks and Benefits Risks Outweigh the Benefits Choice Personal Instrumental/Practical Just Haven t Yet Difficult to Take Time Off of Work Busy Clinic Health Issues Sick at Time of Shot Waiting until Breastfeeding is Complete Waiting for Child to Put More Weight on

12 Vaccination Registry Status Results Response to Vaccination Questionnaire Why Why Not Both Total n (%) n (%) n (%) n (%) None 1 (0.07) 21 (26.6) 0 (0) 22 (1) Partial 108 (7.76) 17 (21.5) 62 (68.9) 187 (12) Complete 1125 (80.9) 1 (1.27) 7 (7.8) 1133 (73) Missing 157 (11.3) 40 (50.6) 21 (23.3) 218 (14) Total 1391 (100) 79 (100) 90 (100) 1560 (100) Partial = received some Complete = received all by 24 months

13 Conclusion & Future Research Found similar themes but the interpretation was different depending on perspective. Future Research: Motivational interviewing 5 Guiding vs. directing style

14 Acknowledgements Partners & Funders We would like to acknowledge the AOB participants and study team. The Research and Innovation team from Alberta Health services. And our funders.

15 Questions?

16 References 1. Public Health Agency of Canada [Internet]. Canada: The Government of Canada; c Canadian Immunization Guide; [about 11 screens]. Available from: 2. Public Health Agency of Canada [Internet]. Canada: The Government of Canada; c National standards for immunization coverage assessment: Recommendations from the Canadian immunization registry network; [about 13 screens]. Available from: 3. Dubé E, Laberge C, Guay M, Bramadat P, Roy R, Bettinger J. Vaccine hesitancy an overview. Hum Vaccin Immunother. 2013;9(8):1-11. Available from 4. Dubé E, Gagnon D, Ouakki M, Bettinger JA, Guay M, Halperin S, et al. Understanding vaccine hesitancy in Canada: results of a consultation study by the Canadian Immunization Research Network. PLoS One. 2016;11(6):1-16. doi: /journal.pone Leask J, Kinnersley P, Jackson C, Cheater F, Bedford H, Rowles G. Communicating with parents about vaccination: a framework for health professionals. BMC Pediatrics. 2012;12:154. doi: /

17 Example Quotes Context Motivation Intrinsic I feel it is safer to vaccinate a child after age of two. Extrinsic Recommendation by naturopath to delay until 2 years if possible unless travelling. Level of Conviction Conviction I believe these illnesses are not common because kids get vaccinated. Want to give my daughter the best chance possible. Lack of conviction Fear caused by health professionals telling me the consequences that could result from not vaccinating. We did wait until he was double the age recommended in most cases.

18 Example Quotes Influencers Experience Personal/Family I am immunized and believe my child should be too. vs. Cause my brother died due to a reaction of vaccine and my dad in-law is alargic to eggs. External Influences Pressured Decided not to continue. Felt pressured to do first 3 imm. but not anymore. It s MY CHOICE! vs. Social pressure and lack of knowledge.

19 Example Quotes Reasons Risk Necessary/unnecessary Feel strongly that vaccinations are necessary for personal and public health. vs. We decided to do homeoprophylaxis instead. We feel there are a lot of unnecessary elements in the vaccines. We also feel that they are too generic, not catering to the individual. Research Because it s smart. Science inconclusive about autism Did much research. vs. I feel there s not enough research on them Effectiveness Believe immunizations to be effective and preventative. vs. None I don t believe they are healthy or effective and can cause neurological implications. Balancing risks and benefits Decided between risks and benefits. Was not comfortable risking kids possible getting very ill or worse. vs. I don t believe that vaccinations provide immunity, and the risks outweigh the benefits. We provided homeoprophylaxis and natural immunity to some illnesses instead.