The Impact of Social Norms on Parents' Vaccination Decisions

Background:
Many factors impact parents' decisions about childhood vaccination. One topic that is often overlooked, however, is social norms—expectations for “normal” behavior that people follow in order to avoid some type of punishment.

Objectives:
The purpose of this presentation is to explain how social norms impact parents' vaccination decisions.

Methods:
In-depth interviews were conducted with parents from King County, WA. All parents were native-born US citizens and had children who were 18 months old or younger at the time of their interviews. Parents differed in terms of age, education, socio-economic status, race/ethnicity, parity and type of vaccination decision made (vaccinate, partially vaccinate, not vaccinate). Interviews were recorded and then transcribed verbatim. A grounded theory approach was used to analyze the interview data.

Results:
While not directly asked about social norms, many parents indicated that these were an important factor in their decision-making. Among parents who decided to completely vaccinate, social norms appeared to be one of the key driving forces. Comments such as “It just seems like something that's required” and “Why wouldn't you vaccinate?” were common. In addition, many of these individuals expressed negative opinions of parents who chose not to completely vaccinate. Among parents who decided to partially or not vaccinate their children, social norms also appeared to play a role in decision-making although to a lesser extent. Some of these parents noted their decisions were driven by conversations with family or friends who had also decided to partially or not vaccinate. Likewise, many of these parents stated that they were careful in sharing their vaccination decisions with others because they did not want to be looked down upon or ostracized.

Conclusions:
Social norms are integral to many parents' vaccination decisions. As such they likely play an important role in current vaccination trends in the US.