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Research Paper

Vaccine knowledge and practices of primary care providers of exempt vs. vaccinated children

Daniel A. Salmon, William K.Y. Pan, Saad B. Omer, Ann Marie Navar, Walter Orenstein, Edgar K. Marcuse, James Taylor, M. Patricia deHart, Shannon Stokley, Terrell Carter and Neal A. Halsey

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Objectives: Compare vaccine knowledge, attitudes, and practices of primary care providers for fully vaccinated children and children who are exempt from school immunization requirements.

Methods: We conducted a mailed survey of parent-identified primary care providers from four states to measure perceived risks and benefits of vaccination and other key immunization beliefs. Frequencies of responses were stratified by type of provider, identified by exempt versus vaccinated children. Logistic regression was used to calculate odds ratios for responses by provider type.

Results: 551 surveys were completed (84.3% response rate). Providers for exempt children had similar attitudes to providers for non-exempt children. However, there were statistically significant increased concerns among providers for exempt children regarding vaccine safety and lack of perceived individual and community benefits for vaccines compared to other providers.

Conclusions: The great majority of providers for exempt children had similar attitudes about vaccine safety, effectiveness, and benefits as providers of non-exempt children. Although providers for exempt children were more likely to believe that multiple vaccines weaken a child’s immune system and were concerned about vaccine safety and less likely to consider vaccines were beneficial, a substantial proportion of providers of both exempt and vaccinated children have concerns about vaccine safety and believe that CDC underestimates the frequency of vaccine side effects. Effective continuing education of providers about the risks and benefits of immunization and including in vaccine recommendations more information on pre and post licensing vaccine safety evaluations may overcome some of these perceptions.

Authors

Daniel A. Salmon

Johns Hopkins Bloomberg School of Public Health; Baltimore, Maryland USA

William K.Y. Pan

Johns Hopkins Bloomberg School of Public Health; Baltimore, Maryland USA

Saad B. Omer

Johns Hopkins Bloomberg School of Public Health; Baltimore, Maryland USA

Ann Marie Navar

Duke University; School of Medicine; Durham, North Carolina USA

Walter Orenstein

Emory University; College of Medicine; Atlanta, Georgia USA

Edgar K. Marcuse

Children's Hospital and Medical Center; Seattle, Washington

James Taylor

University of Washington; Child Health Institute; Seattle, Washington USA

M. Patricia deHart

Washington State Department of Health; Immunization Program; Olympia, Washington USA

Shannon Stokley

Centers for Disease Control and Prevention; National Center for Immunization and Respiratory Diseases; Atlanta, Georgia USA

Terrell Carter

The PATH Malaria Vaccine Initiative; Seattle, Washington USA

Neal A. Halsey

Johns Hopkins Bloomberg School of Public Health; Baltimore, Maryland USA

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If the document does not open, please right-click on the link (control-click on a Macintosh) and select the option to save the file to disk.