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Survey: Parental Concerns About Childhood Vaccines Print E-mail
Living - Health & Fitness
TS-Si News Service   
Tuesday, 19 April 2011 09:00
Aurora, CO, USA. A national survey of primary care physicians who deliver vaccinations to children found that a majority of physicians think that the level of concern expressed by parents about vaccines has either greatly or moderately increased in the past five years.

The physicians report they spend a significant amount of time at well child visits discussing vaccine safety with parents.


In a typical month, 79 percent of physicians report at least one vaccine refusal; 8 percent report refusals for more than 10 percent of children. And, 89 percent report at least one request to spread out vaccines — 20 percent report these requests for more than 10 percent of children.



Allison Kempe, MD, MPH, is professor of Pediatrics at the University of Colorado School of Medicine.

Kempe is the director of the Children’s Outcomes Research (COR) Program at The Children’s Hospital.

The findings of the research team led by Kempe appear in the American Journal of Preventive Medicine (AJPM).

Allison Kempe also is the 2011 winner of the Academic Pediatric Association Research Award.

The award recognizes her for research that has led to improved child health policies in health disparities among underserved populations.

Her findings have had a measureable impact on the funding for state Children's Health Insurance Programs, as well as immunization delivery, policies and practices.The report observes that relying only on discussion of vaccines at visits where vaccines are needed may be too time-consuming and inadequate and may compromise the providers’ ability to focus on other important health care topics. Other study findings include the following:
  • 40 percent of physicians always or often require parents to sign a form if they refuse a vaccination. Most physicians would agree to spread out vaccines in the primary series at least sometimes.

    Approximately 10 percent of physicians would often or always dismiss families from their practice if they refuse vaccines in the primary series and another 5 percent would sometimes do so.

  • Although few physicians had considered no longer providing vaccines because of the need to discuss vaccine risks and benefits, about one-third of physicians reported that these discussions were negatively impacting their job satisfaction.

  • From the physicians’ perspective the most successful messages in convincing skeptical parents were personal ones, such as the fact that they vaccinated their own children or grandchildren, discussions of their personal experiences with vaccine safety or with vaccine-preventable diseases, or a statement that they think it is safer to vaccinate than not to vaccinate.”
Primary care providers in this country have been doing a terrific job trying to counter the misinformation about vaccine safety that is so abundant on the internet and other media, but they are spending a great deal of their time at well visits discussing these issues alone,” said Kempe.

“The amount of time physicians have in a well child care visit to cover a lot of health care topics is very limited and they are not being paid for the lengthy discussions some parents with concerns need to have.

Most importantly, they may have to compromise other health care topics if these discussions are long. Clearly, primary care physicians would benefit from a multi-pronged approach, with greater use of educational methods before visits or different educational forums such as group visits and much more effective use of media and social marketing to counter misinformation.”

Kempe believes the multi-pronged approach should include the following:
  • Increased use of social marketing aimed at vaccine hesitant parents.

  • Efforts to directly counter misinformation about vaccines in the media, on talk shows and on the internet — actively involving parents in this effort may be key in engaging those who are suspicious of “experts” or governmental agencies.

  • Increased use of more efficient educational methods at the practice such as prenatal visit consultations, group parent meetings, internet site recommendations or mailed materials for parental education prior to well visits.

  • More physician training in effective discussions of risk and benefits of vaccines.

  • Physicians need to be able to bill for time spent discussing parental concerns that are outside of the time usually allotted for well visits.

  • Physicians may be most effective if they use personal messages in their discussions of the risks and benefits of vaccines such as their own decisions to vaccinate their children.

CitationPrevalence of Parental Concerns about Childhood Vaccines: The Experience of Primary Care Physicians. Allison Kempe, Matthew F. Daley, Mary M. McCauley, Lori A. Crane, Christina A. Suh, Allison M. Kennedy, Michelle M. Basket, Shannon K. Stokley, Fran Dong, Christine I. Babbel, Laura A. Seewald, L. Miriam Dickinson. American Journal of Preventive Medicine (AJPM) 2011; 40(5): 548-555.

Abstract

Background. Little is known about the effects of increased parental vaccine safety concerns on physicians' vaccine communication attitudes and practices.

Purpose. To assess among pediatricians and family medicine (FM) physicians: (1) prevalence of parental requests to deviate from recommended vaccine schedules; (2) responses to such requests; and (3) attitudes about the burden and success of vaccine communications with parents.

Methods. Survey of nationally representative samples of pediatricians and FM physicians (N=696) conducted during February to May 2009 with analysis in 2010.

Results. Response rates were 88% for pediatricians and 78% for FM physicians. Overall, 8% of physicians reported that ≥ 10% of parents refused a vaccine and 20% reported that ≥10% of parents requested to spread out vaccines in a typical month. More pediatricians than FM physicians reported always/often requiring parents to sign a form if they refused vaccination (53% vs 31%, p < 0.0001); 64% of all physicians would agree to spread out vaccines in the primary series at least sometimes. When talking with parents with substantial concerns, 53% of physicians reported spending 10–19 minutes and 8% spending =20 minutes. Pediatricians were more likely than FM physicians to report their job less satisfying because of parental vaccine concerns (46% vs 21%, p < 0.0001). Messages most commonly reported as “very effective” were personal statements such as what they would do for their own children.

Conclusions. The burden of communicating with parents about vaccines is high, especially among pediatricians. Physicians report the greatest success convincing skeptical parents using messages that rely on their personal choices and experiences.

TS-Si News ServiceThe TS-Si News Service is a collaborative effort by TS-Si.org editors, contributors, and corresponding institutions. The sources can include the cited individuals and organizations, as well as TS-Si.org staff contributions. Articles and news reports do not necessarily convey official positions of TS-Si, its partners, or affiliates.

We welcome your comments. Use the form below to leave a public comment or send private correspondence via the TS-Si Contact Page. We will not divulge any personal details or place you on a mailing list without your permission.


TS-Si is dedicated to the acceptance, medical treatment, and legal protection of individuals correcting the misalignment of their brains and their anatomical sex, while supporting their transition into society as hormonally reconstituted and surgically corrected citizens.

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Survey: Parental Concerns About Childhood Vaccines
Tuesday, 19 April 2011

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Last Updated on Monday, 18 April 2011 19:24
 
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