Understanding Rationales for Parental Concerns Associated with Immunization Exemption

Background:
Utah is one of 20 states that allow medical, religious, or personal exemptions to immunizations. Between 1997 and 2004, immunization exceptions increased from 1.2% to 3.0% (Green & Lee, 2006). As Utah has the highest birthrate and highest average family size in the nation (Green & Lee), the issue of increasing immunization exemptions must be researched and then addressed.

Objectives:
The objective of this study was to identify and understand reasons behind parents' desire to exempt their children from routine, required immunizations.

Methods:
An exemption form must be provided to every health department in the state of Utah if parents choose to exempt their children from receiving required vaccinations. During 2006-2007, each parent who requested an exemption form was also given a short, one-page survey composed of closed and open-ended questions to explore the reasons why they chose to claim personal or philosophical exemption to immunizations. During the survey period, 801 parents voluntarily completed and submitted the survey attached to the state exemption form.

Results:
The most commonly identified reasons parents claimed immunization exemptions included parents not possessing their child's immunization record, fears regarding a possible relationship between autism and immunizations, concerns about adverse reactions and about children being too young to receive so many vaccinations, and personal or religious beliefs.

Conclusions:
As immunization exemption rates in Utah continue to increase, measures must be taken to identify and address the motives and concerns of parents. This study has recognized the most common factors which influenced parents' decision to claim immunization exemptions. The identified rationales can aid the nursing and medical community in recognizing where education and information regarding immunizations can be improved.