BACKGROUND:
Oregon law requires school children to be fully immunized or face exclusion from school. Oregon also has a broadly defined religious exemption, based on personal belief. The schools in Ashland, (pop=19,772), have the highest rates in Oregon, with over 12% of public school children having an exemption. Initial concerns included whether this represents convenience exemptions, or a core of anti-vaccine sentiment.

OBJECTIVE:
The Community Vaccination Survey (CVS) was developed to determine factors behind parental and community non-acceptance of vaccination.

METHOD:
The CVS was sent to 654 Ashland families with children at the start of the 2002/2003 schoolyear, with an over-sample of exempt families.

RESULT:
Overall 63% of non-exempt and 61% of exempt families responded to the survey. The majority, 58%, had concerns about vaccine safety, and 18% doubted whether vaccines prevent disease. Only 2% of exempt parents felt vaccines were safe. While exempt and non-exempt parents reported similar rates of exposure to media accounts of hurt children, exempt parents were 4.3 times more likely to report knowing someone with a hurt child.

CONCLUSION:
The CVS findings suggest that the balance of perceived risk and benefit to vaccination is important in the decision to seek an exemption. Negative personal or community messages about vaccination, or lack of belief in vaccine efficacy, were important for progressing from safety concerns to exemptions. Providers and the types of advice or discussion they gave had strong associations with parent’s perceptions of risk and benefit. Receiving a mixed message about vaccines from any healthcare provider was associated with higher rates of exemptions.

LEARNING OBJECTIVES:
Participants will learn about the CVS and factors related to community anti-vaccination sentiment. Discussion will include the impact of anti-vaccine sentiment on neighboring communities, as well as possible interventions suggested by the survey.