Confidence in Context – Parents Confidence in Vaccines and Other Health-Related Products for Young Children

Theoretical Background and research questions/hypothesis:  Coverage rates in the United States for most recommended childhood vaccinations are at or near historical highs according to 2014 National Immunization Survey data, but recent studies suggest more U.S. parents are choosing to delay or decline some recommended vaccines. Concerns about vaccine hesitancy have also resulted in the National Vaccine Advisory Committee and the World Health Organization issuing reports calling for greater attention to vaccine confidence. While some studies have assessed parents’ vaccine-related confidence levels, no published studies have not attempted to put vaccine-related confidence into a broader context. It is thus not known if parents have more confidence, or less confidence, in other health-related products they make decisions about for their young children, such as antibiotics, over-the-counter medicines, and vitamins. It is also not known if confidence levels are associated with the same or different parent sub-populations when it comes to these different product categories or what characteristics are associated with different parent segments.

Methods:  An Internet-based survey of 1,000 parents of children 5 years old and younger drawn from a nationally representative panel conducted between November 3 and December 1, 2014. Study measures include confidence, belief, and behavior items related to vaccines, antibiotics, over-the-counter (OTC) medicines, and vitamins for young children.

Results:  Most parents were confident in the value, effectiveness, and safety of recommended vaccines, antibiotics, OTC medicines, and vitamins for young children, with vaccines associated with the highest confidence levels. For all products, confidence levels were associated with use behavior to date, future intentions, past product experience, and some demographic variables. In general, parents lowest in vaccine confidence also had relatively low confidence in antibiotics and OTC medicines.

Conclusions:  The results from this study provide helpful perspective regarding vaccine confidence. One, the results are reassuring with respect to parents of young children. Most have relatively high confidence in recommended vaccines. However, the results also suggest that vaccine communicators should have realistic expectations regarding what is possible to achieve in terms of confidence ratings. Even the most confidence parents in this study appear to recognize there are limits when it comes to health products’ safety, value, and effectiveness.  The results also provide evidence of strong and consistent associations between confidence levels and hesitancy, including showing that low confidence is associated with higher hesitancy and higher probability of vaccination delay. In addition, the results indicated this was most likely to occur among parents with less formal education and lower household incomes. Finally, the results illustrated that indirect experience – e.g., seeing a media story on an adverse event – can impact parents more than direct experience.

Implications for research and/or practice: Confidence is associated with vaccination and other health product behaviors and behavior intentions, and communications efforts should seek to foster confidence. Measuring confidence can identify sub-populations whose hesitancy is affecting their willingness to adopt recommended actions. Findings also suggest that when it comes to strengthening vaccine confidence, communication efforts should place a priority on those with less formal education and lower household incomes.