Why parents refuse childhood vaccination: a qualitative study using online focus groups

Area of Science:

• Public Health
• Pediatric Medicine
• Qualitative Research

Background:

• Routine childhood vaccinations significantly reduce vaccine-preventable diseases in high-income countries.
• A subset of parents question or refuse vaccinations for their children, necessitating further investigation.
• No prior qualitative studies explored parental vaccination refusal decisions among Dutch parents.

Purpose of the Study:

• To explore the factors influencing vaccination refusal decisions among Dutch parents.
• To understand the perspectives of parents who opt out of the National Immunization Program (NIP) for their young children.

Main Methods:

• Conducted eight online focus groups with 60 Dutch parents of children aged 0-4 years who refused some or all NIP vaccinations.
• Employed thematic analysis to identify key factors influencing parental decisions regarding childhood immunizations.
• Utilized online focus groups as an effective method for qualitative data collection in this population.

Main Results:

• Vaccination refusal was associated with lifestyle factors, perceptions of the child's body and immune system, and perceived risks versus benefits of disease and vaccination.
• Negative prior vaccination experiences and social influences also played a role in parental decisions.
• Online focus groups provided rich, meaningful data for understanding complex parental attitudes towards vaccination.

Conclusions:

• Current National Immunization Program (NIP) information is inadequate for parents who refuse vaccinations.
• Improved parental understanding of immunity, disease susceptibility, and vaccine risk-benefit profiles may foster trust and informed decisions.
• Public health communication should clarify that the NIP is recommended but not mandatory to address parental concerns.