What Factors Contribute to Suboptimal Childhood Immunization Rates?

University of Vermont third-year medical student Catherine Kelley, right, explains details of the "Understanding Factors Contributing to Suboptimal Rates of Childhood Vaccinations in Vermont" public health project to associate professor of medicine Anne Dixon, MD, at the 2011 Public Health Projects Poster Session and Celebration held in the College of Medicine's Hoehl Gallery in January.

Childhood immunizations long proven invaluable in preventing contagious diseases have become increasingly controversial. Despite numerous studies supporting safety and efficacy, a growing number of parents refuse to vaccinate their children. A study conducted by second-year University of Vermont (UVM) medical students identified several potential causes for drops in Vermont children's immunization rate, which ranks as one of the lowest nationally.

Results of the groups 22-question survey showed that the primary reasons for refusal to vaccinate include potential side effects and a belief that the diseases vaccinated against are not harmful. The survey, which covered parents healthcare knowledge about their children, vaccination concerns, and vaccination status, was sent to participants of Vermonts Women Infant and Childrens Program at two district health offices. A total of 82 percent (n=386) of respondents reported their children had received all the recommended vaccinations for their age. Respondents who were age 30 and over (p=0.01) or had less education (p<0.01) were significantly associated with reporting their children as current on vaccinations.

Respondents who considered themselves highly knowledgeable about their child's healthcare (p=0.01) and confident about vaccine safety (p<0.01), were significantly associated with reporting children as being current on vaccinations. Intent for future vaccination was predicted by both healthcare knowledge (p<.01) and confidence in vaccine safety (p=0.02). The student group concluded that respondents were most concerned about safety and number of vaccinations administered during one visit. In addition, the group identified that primary care providers play a critical role in addressing parental concerns and therefore, could play an equally critical role in improving vaccination rates. They believe this approach could be replicated elsewhere to improve immunization rates.

Representatives of the research group will present their findings at the American Public Health Association annual meeting in Washington, D.C. on Oct. 30, 2011. Collaborators on the study project include UVM College of Medicine Class of 2012 students Adam Bensimhon, Kuang-Ning Huang, Paul Jarvis, Jonathan Jolin, Catherine Kelley, Kurt Schaberg, and Cristine Velazco, as well as advisors Marianne Burke, MLS, director of the University of Vermont Dana Medical Library, Christine Finley, RN, MPH, immunization program chief of the Vermont Department of Health, Thomas V. Delaney, PhD , UVM research associate in pediatrics, and Jan Carney, MD, MPH, UVM associate dean for public health, research professor of medicine, and course director for Public Health Projects.