Parents’ social networks can play a substantial role in decision making about whether to vaccinate their children, according to an online survey study.
The study examined two types of social networks: "people" networks, comprising family members, friends, and health care providers; and "source" networks, which included books, magazines, news programs, and the Internet. Results showed that of all variables considered in the study, people networks were the most influential in parents’ decision making, particularly in parents who did not conform to recommended vaccination schedules.
"These results suggest that social networks, and particularly people networks, play a key role in shaping parents’ vaccination decisions," wrote study author Emily K. Brunson, M.P.H., Ph.D., of the department of anthropology at Texas State University, San Marcos (Pediatrics 2013;131:1-8 [doi:10.1542/peds.2012-2452]).
©Micah Young/istockphoto.com
Parents labeled as ‘nonconformers’ were more likely to have misgivings about childhood vaccinations.
Participants were first-time parents born in the United States with children aged 18 months or younger. All parents surveyed were residents of King County, Wash., a region known for below-average rates of vaccination. Dr. Brunson examined 196 eligible parents, of which 126 conformed to the nationally recommended vaccination schedule (conformers), and 70 who either delayed vaccination, vaccinated only partially, or did not vaccinate their children at all (nonconformers).
Parents completed an online survey consisting of three modules. The first asked participants about the people and sources they consulted for vaccination-related information and advice. Parents were asked to list their top five sources of vaccination information, as well as the advice provided by each person or source. The second module asked parents about their existing practices and attitudes toward vaccination, and the final survey module collected demographic information about the parents and their households.
Survey results showed "significant differences" in vaccination attitudes between conformers and nonconformers. Nonconformers were more likely to have negative perceptions of vaccination, and only 51% reported the intent to have their children fully vaccinated by the time they started kindergarten (vs. 100% of conformists). The findings also reported that 72% of people in the nonconformers’ social networks recommended nonconformity, as opposed to just 13% of people in the conformers’ networks.
Both groups ranked health care providers in their top five influential network members, although Dr. Brunson notes that in spite of health providers’ important role in their decision making, "the percent of network members recommending nonconformity was the most-important" predictor of parents’ vaccination decisions.
Dr. Brunson reported a few limitations to this study. The data were not collected as a random sample, meaning the results cannot be inferred as being representative of all parents in King County. Second, she noted that because of the study’s use of retrospective network data, "it is possible that recall bias may be an issue."
The author also reported that the sample size was not large enough to account for differences between types of nonconformity (such as delayed vaccination vs. no vaccination). Lastly, this report treats conformers and nonconformers as "cohesive groups". Although this is commonly done, Dr. Brunson wrote that this approach is "likely incorrect."
Because this study demonstrates the significant role of parents’ social networks in vaccination decision making, this area should continue to be studied, said Dr. Brunson. She also suggested that any future attempts to increase the acceptance of vaccinations should focus on the inclusion of these broad social networks, rather than just parents and health care providers.
This study was based on research supported by a grant from the National Science Foundation. Dr. Brunson reported no relevant financial disclosures.