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Vaccine decision making in a vaccine-hesitant community: Marin County, California
Monday, November 17, 2014
Communities with low vaccination rates are more vulnerable to outbreaks of vaccine preventable diseases. In Marin County the rate of kindergarten parents seeking Personal Belief Exemptions (PBEs,) non-medical exemptions from required school immunizations is nearly four times the California average and increased from 3 .7% in 2002 to 7.8% in 2012;. In 2014, California implemented legislation requiring parental conversations with medical professionals before receiving PBEs. This Marin Childhood Vaccination Survey explored local vaccine decision-making to equip providers and the community for the conversations required under the new law. Survey topics included exemption status, vaccine information sources, and vaccine behaviors and beliefs. In late 2013, immunization coordinators of 40 public and private schools distributed the survey to kindergarten parents. Of 493 respondents, 85% (417) had fully-vaccinated children and 8% (39) had PBEs. More parents with PBEs received vaccine information from complementary and alternative providers (54%) compared to parents without PBEs (4%). Fewer parents with PBEs received vaccine information from healthcare providers (87%) compared to parents without PBEs (99%). Of kindergartners with PBEs, 84% had at least one of the school entry vaccines, 64% were up to date with DTaP while 6% had met the hepatitis B requirements. Parents with PBEs believed that children get too many vaccines at the same time (100% agreed) or that vaccines contain unsafe toxins (62%). Parents also reported distrust in the healthcare system and low perceived risk of certain vaccine-preventable diseases. Addressing vaccine concerns revealed in this study can improve communication between providers and vaccine-hesitant parents.
Planning of health education strategies, interventions, and programs
Protection of the public in relation to communicable diseases including prevention or control
List the differences in sources of vaccine information between parents with Personal Belief Exemptions (PBEs) from school-entry immunizations and parents with no exemptions.
Describe the coverage of individual vaccines among kindergarten students with PBEs.
Discuss the most common reasons that parents state for requesting PBEs for their kindergarten students.
Keyword(s): Child Health Promotion, Community Health Planning
Presenting author's disclosure statement:
Qualified on the content I am responsible for because: I have been the principal investigator of the study exploring vaccine decision-making among parents in Marin County, California. I am a CDC/CSTE Applied Epidemiology Fellow in County of Marin Department of Health and Human Services. My professional interests are health behaviors and the prevention of communicable diseases.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.