Elsevier

Vaccine

Volume 24, Issues 37–39, 11 September 2006, Pages 6351-6355
Vaccine

An internet-based survey on parental attitudes towards immunization

https://doi.org/10.1016/j.vaccine.2006.05.029Get rights and content

Abstract

Parental misperceptions have been identified as major barriers towards immunizations in children. By use of a German internet vaccine forum for lay persons, a survey was performed to assess current attitudes of parents regarding prevalent issues related to childhood vaccination. Of 6025 participants, 5722 (95.0%) regarded their paediatrician as the most important source of information regarding immunization, followed by leaflets (48.0%), health magazines (44.7%), and the internet (38.7%). Of currently generally recommended childhood immunizations, those against pertussis, Hib and especially measles–mumps–rubella were considered least important by parents. Furthermore, 22.6% of survey participants felt that immunizations are administered “too early” in life and 21.0 and 12.2% thought that overload of the child's immune system and induction of allergies, respectively, would be side effects of immunizations. This survey provided information on prevalent parental attitudes towards immunization, which should be used to plan information strategies to counteract existing misperceptions.

Introduction

Immunization rates against measles, mumps, and rubella (MMR), pertussis, Haemophilus influenzae type b (Hib), and pertussis are still suboptimal in Germany [1]. Parental concerns regarding the safety of vaccines and their belief that many vaccine-preventable diseases are harmless have been identified as common barriers to immunization in childhood [2], [3], [4], [5], [6]. Amazingly though, some specific safety issues that have caused concerns in individual countries did not spread to other geographic areas, e.g. the alleged associations between MMR and autism in the United Kingdom and the United States of America and between hepatitis B immunization and demyelinating diseases in France [7], [8], [9], [10]. Therefore, prevailing parental attitudes toward vaccine safety issues need to be analysed in individual countries to be able to specifically counteract most common misperceptions.

Little is known about reasons why some parents decline vaccination of their children in Germany. In autumn 2001, a “vaccine forum” has been introduced to a public website mainly dedicated to health related issues for lay persons in Germany (http://www.rundumsbaby.de, translated: “all about the baby”). The vaccine forum is hosted by the author of this report, who answers to immunization related questions by anonymous lay persons. All questions and answers can be accessed freely at any time on the website. The website is mainly used by German parents and, to some extent, by German speaking parents from neighbouring countries (e.g. Austria and Switzerland). It has previously been shown that this website can successfully be used to address research questions by means of a user survey [11]. We therefore took advantage of this website to perform a survey regarding current parental beliefs toward specific vaccine related questions with the goal to identify major barriers to vaccination which could be counteracted by specific information campaigns in the future.

Section snippets

Methods

A self-administered questionnaire was placed on the website http://www.rundumsbaby.de during the week May 12–17, 2004. It comprised 13 questions with multiple-choice answers. The estimated time to complete the survey was 10–15 min. During the survey period, a note was placed on the website with information about the purpose of the survey. Moreover, the survey was advertised in the website's newsletter beginning of May 2004, which was distributed to approximately 62,000 individuals throughout

Results

During the 6-day survey period the internet forum was accessed by 20,726 visitors and 6025 questionnaires were filled in. However, not every question was answered by all participants and therefore denominators may vary in the following analyses.

The overwhelming majority of participants (5722/6025 = 95.0%) named their paediatrician as the most important source of information regarding immunization and parental demand for information was “detailed” or “very detailed” in 91.6%. Specifically,

Discussion

This survey on parental attitude towards childhood immunizations was successful with a high number of participants (n = 6025). As was expected based on the subject of the website, it can be inclined from the answer to question number (4) that more than 95% of participants were parents of (presumably young) children. Several relevant conclusions can be drawn from the results of this survey:

  • (1)

    The overwhelming majority of participants expressed positive experience with immunizations in their children

Acknowledgements

Assistance in performance of this survey by Ulrich Schneider, owner of “http://www.rundumsbaby.de” (USM, Ulrich Schneider Multimedia, Tegernsee, Germany) is gratefully acknowledged. The website receives financial support from various companies including one vaccine manufacturer (Sanofi Pasteur MSD, Leimen, Germany) who also supported this survey with an unrestricted grant to the webmaster.

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