The Association Between Parental and Provider Vaccination Beliefs: A Case Control Study

Background: Health care providers have a great deal of influence on parental vaccination decisions. Over 90% of parents reported receiving vaccine information from their child’s health care provider. The majority of vaccinated and exempt children’s parents reported their child’s primary health care provider was a good or excellent source for vaccine information. Yet, the role of health care providers in impacting parents who refuse vaccines has not been fully explored.

Objectives: Determine if vaccine related knowledge, attitudes, and beliefs of health care providers are similar to vaccine related knowledge, attitudes and beliefs of parents.

Methods: We surveyed parents and primary care providers of vaccinated and unvaccinated (exempt) school age children in four states. The survey instrument measured perceived risks and benefits of vaccination and other key immunization beliefs. Binomial regression analysis was used to calculate the odds ratios for associations between parental and provider responses.

Results: Surveys were completed by 1367 parents (56.1% response rate) and 551 eligible providers (84.3% response rate). Many key immunization beliefs were associated between parents and providers. For example, parents with high confidence in vaccine safety were likely to have providers with similar attitudes although parental and provider reporting of disease susceptibility and severity and vaccine efficacy were not associated. Parents whose providers agreed that children get more immunizations than are good for them had 4.9 higher odds of holding that same belief compared to parents whose providers do not have that belief.

Conclusions: These findings suggest the knowledge, attitudes and practices of health care providers, including those regarding vaccine safety, may have a contributing effect on parental decision to accept or forgo vaccination. The findings also indicate that parents may be more likely to choose providers who have similar attitudes and beliefs to their own.