BACKGROUND:
Laws in all 50 states require children to be vaccinated before school entry.

OBJECTIVE:
To examine attitudes and beliefs of parents regarding compulsory vaccination, and determine factors associated with opposition to compulsory vaccination.

METHOD:
We analyzed data from the 2002 HealthStyles survey. We described parents who supported and opposed school vaccination requirements, and used bivariate and multivariate analyses to identify variables associated with opposition to compulsory vaccination.

RESULT:
The response rate for the HealthStyles survey was 72%. 1934 respondents with at least one child aged 0-18 years were used for analysis. 12% of parents opposed compulsory vaccination. Parents’ beliefs regarding compulsory vaccination were significantly associated (p<0.05) with beliefs in the safety and utility of vaccines, and with sociodemographic factors. The final multivariate model showed that parents who opposed compulsory vaccination were more likely to believe that the body can protect itself from vaccine-preventable diseases on its own (Odds Ratio [OR]=2.4, 95% Confidence Interval [CI]=1.6-3.6), and that vaccines are unimportant or only somewhat important to children’s health (OR=1.9, 95% CI=1.2-3.2). These parents were also more likely to report that their youngest child had not or would not receive all recommended vaccines (OR=3.8, 95% CI=1.8-8.2). Opposition was not associated with philosophical exemption availability.

CONCLUSION:
Parents who were opposed to compulsory vaccination were more likely to believe that vaccines are not important to children’s health, and were also more likely to report that their youngest child had not or would not receive all recommended vaccinations. It is important for public health practitioners to develop and target educational interventions to address the concerns of these parents.

LEARNING OBJECTIVES:
Describe three characteristics of parents of children aged 0-18 years who supported and opposed compulsory vaccination in the 2002 HealthStyles survey.
Identify three factors associated with opposition to compulsory vaccination among parents of children aged 0-18 years in the 2002 HealthStyles survey.