Vaccine knowledge, attitudes, and behaviors of New Mexico (NM) vaccine exemptors

The New Mexico (NM) Department of Health requires a formal exemption process for children who cannot show documentation of required vaccination before daycare/school attendance. NM vaccine exemption rates have increased threefold since 1999. A telephone survey was designed to characterize NM families submitting exemption forms.

Telephone interviews were attempted with all NM families who requested a 2011 exemption. Respondents were assigned to “slightly/somewhat hesitant” and “very hesitant” groups based on self-described vaccine hesitancy level. Chi-square tests were performed to identify differences in modifiable knowledge, attitudes and behaviors between groups (p≤0.05).

Of 3,372 eligible vaccine exemptors, 729 families completed interviews. Analysis was limited to slightly/somewhat hesitant (286) and very hesitant (389) respondents. While a similarly high proportion of both groups felt they were knowledgeable about vaccines (97% and 99%, respectively) and felt comfortable discussing vaccine concerns with their child’s provider, there were significant differences in their beliefs. Slightly/somewhat hesitant parents more often agreed that vaccines are important to prevent community disease spread (75% vs. 32%, p≤0.05), while very hesitant parents were more likely to report that they felt some vaccines caused autism (72% vs. 48%, p≤0.05), that natural immunity (by getting the disease) was better than vaccines (72% vs. 47%, p≤0.05), and that they could adequately protect their children without vaccines (86% vs. 51%, p≤0.05). The perception of “harmful additives” was important to both groups, while a larger proportion of slightly/somewhat hesitant parents reported they would vaccinate their children using an alternative schedule. Significant differences were also noted in vaccine information source and primary care provider choice.

Several vaccine-related belief differences were identified between slightly/somewhat hesitant and very hesitant families. Results will allow the state health department to tailor vaccine messaging.