ARE PARENTS AVOIDING VACCINATIONS BECAUSE OF SAFETY FEARS? A NATIONAL PICTURE FROM PARENTS AND PEDIATRICIANS Lynn M. Olson, Moira Inkelas, Karen G. O'Connor, Neal Halfon DOPR, American Academy of Pediatrics, Elk Grove Village, IL; Pediatrics, ULCA, Los Angeles, CA

BACKGROUND: Media reports suggest there may be substantial fears and misinformation regarding the safety of childhood vaccines. However, there are few data on the degree to which such fears are reducing the proportion of children immunized.

OBJECTIVE: Obtain national reports from parents and pediatricians regarding the degree to which parents are delaying or refusing childhood vaccines due to safety concerns.

DESIGN/METHODS: National telephone survey of parents of children 4-35 months, National Survey of Early Childhood Health (NSECH) (year = 2000, n = 2,068). Data are weighted to represent all US preschoolers, including an adjustment for non-telephone households. National random sample, mailed Periodic Survey of AAP members (year =2000, n = 811).

RESULTS: Overall 7.6% of parents report that in the past 12 months (or since birth) they had missed or delayed a vaccine for their child aged 4-35 months. In both bivariate and logistic regression analyses refusal/delay is not associated with family income, public vs private insurance, mother's age, or region of the country. Modest effects are found for lower global ratings of child health (OR 1.9) and Hispanic ethnicity (OR .55). Substantial portions of pediatricians report that in the past 12 months no parents delayed or refused a vaccine: 41% report no parents of children 0-9 mos refused/delayed; 48% report no parents of children 10-18 mos; and 64% report no parents of children 19-35 mos. Among pediatricians with parents who refused or delayed a vaccine, the proportion of patients affected is usually small. In these practices the mean percentage of parents of children 19-35 months refusing or delaying vaccines is 4.6 (median = 2.0), and about one in ten pediatricians report 10% or more of parents are avoiding vaccines because of safety concerns.

CONCLUSIONS: Reports from parents and pediatricians indicate that vaccine safety concerns are translated into delay or refusal to immunize in some cases, however the problem is not affecting large segments of the population. National parent data indicates those who are avoiding vaccines are not readily characterized. Data from pediatricians suggest about half of practices have no problems, while a subset are experiencing substantial numbers of parents with vaccine fears. Ongoing monitoring is needed to identify trends and specific vaccine concerns.