Birds of a Feather Vaccinate Together

Vaccination decisions influenced by social networks of parents

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Plenty of research has established the safety of vaccines and the low risks for serious side effects. Yet some parents still don't vaccinate their children. What influences their decisions?

A recent study shed some light on that question. Parents' decisions about vaccinating their children appeared to be influenced by their social networks.

Those who did not follow the CDC recommended schedule were more likely to have friends and other sources that recommended different options.

Meanwhile, those who did follow the CDC recommended schedule were less likely to hear or read suggestions for delaying or selectively vaccinating their children.

"Follow the CDC immunization schedule."

The study, conducted by Emily K. Brunson, MPH, PhD, of the Department of Anthropology at Texas State University in San Marcos, looked at how influential parents' social networks tend to be in their decisions to vaccinate their children.

The author focused on 196 first-time parents in King County, Washington, an area with lower vaccination rates than the state and national average. The parents had all been born in the US and had children up to 18 months old.

The parents were considered either "conformers" or "non-conformers." The 126 conformers were parents who followed the vaccination schedule recommended by the Centers for Disease Control and Prevention.

Non-conformers were those who did not follow the CDC schedule. They either did not vaccinate their children at all, or they vaccinated their children using a delayed or selective method.

In this study, the 70 non-conformers included 28 parents who were completely vaccinating but on a delayed schedule, eight parents who were partially vaccinating while following the CDC schedule, 29 parents who were partially vaccinating on a delayed schedule and five parents who were not vaccinating at all.

The education levels, household income and other demographics of the parents in both groups were similar. However, the non-conformer parents tended to have more negative views about vaccination and were less likely to plan to have their children fully vaccinated by kindergarten.

All the parents completed an extensive online survey that involved three parts. The first part asked parents about the people and sources they consulted for information and advice on immunization decisions.

The second part asked parents about their vaccination decisions and about their perceptions of vaccines and vaccine-preventable diseases. The third part included basic information about the parents and their families.

Dr. Brunson found that 72 percent of the people that non-conformers consulted about vaccination recommended not following the CDC schedule.

Meanwhile, only 13 percent of the people that conformers consulted recommended not following the CDC schedule.

However, parents in both groups tended to rank their healthcare providers in the list of the top five people they relied on most heavily for vaccination information and advice.

The parents in both groups also ranked their spouse or partner as the most important person influencing their vaccination decisions.

Dr. Brunson found that non-conformer parents tended to have a higher number on average of "network members" – people they consulted related to vaccines. Non-conformers had an average of 6.7 people in their networks, compared to an average of 4.8 people in the conformers' networks.

Others listed in the parents' networks included friends, family members, coworkers, parenting class instructors, doulas, midwives and university professors.

A similar pattern of recommendations was seen in the non-person sources that the parents consulted for vaccination information or advice.

Dr. Brunson found that 59 percent of the sources that non-conformer parents consulted recommended delayed, selective or no vaccination at all. Only 20 percent of the conformers' sources recommended something other than the CDC schedule.

In general, those who did not conform to the CDC schedule tended to rely most on books for their information. Meanwhile, conformers tended to rely more on the Internet. The differences between these, however, was very small.

Parents also used scientific studies, parenting class handouts, doctor's office handouts, public health mailings and local and national news programs as sources of information.

Paul Offit, the Chief of Infectious Diseases at the Children's Hospital of Philadelphia and an expert on vaccines and coinventor of the rotavirus vaccine, was not surprised by these results.

He said it makes a lot of sense that people are influenced by their friends and family and what they read online. However, he still believes the doctor is the most important person related to this decision for parents.

"The single greatest influencer is the physician's or the nurse's attitude," Dr. Offit said. "That's the most influential moments without question."

The study was published April 15 in the journal Pediatrics. The research was funded by the National Science Foundation. The author had no conflicts of interest to disclose.

Reviewed by: 
Review Date: 
April 14, 2013
Last Updated:
January 21, 2014