Parental decision-making about H1N1 vaccines for children

Although designated as a high-risk group during the 2009-2010 H1N1 pandemic, only about 40% of US children received the vaccine, a relatively low number compared high-risk groups in seasonal influenza, such as the elderly, whose vaccine rates typically top 70%. To better understand parental decision-making and predictors of acceptance of the H1N1 vaccine, we examined data from a representative national sample of parents (n=694), using the Health Belief Model as a framework. Surprisingly, higher perceived levels of H1N1 risk were not associated with vaccine uptake. The most important predictors of vaccine acceptance were “cues to action” at multiple levels, from intra-personal to mass communication, including the influence of friends, family, the media, and modeling by the Obama family (even after controlling for political ideology & race); perceived costs & benefits of the vaccine and perceived self-efficacy were also significant predictors of uptake. Results suggest that traditional measures of perceived risk may not account for the cost-benefit analysis inherent in vaccine decision-making, and that messages designed to emphasize disease risk may be ineffective. The authors recommend emphasizing cues to action that support norming and modeling of vaccine acceptance.