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Timing of Vaccine Decision-Making Among First-Time Parents

  • Author Footnotes
    1 Previously affiliated with the University of North Carolina School of Medicine, the home institution.
    J. Nathan Yarnall
    Correspondence
    Address correspondence to J. Nathan Yarnall, MD, MPH, Emory University School of Medicine, 100 Woodruff Circle, Atlanta, GA 30322
    Footnotes
    1 Previously affiliated with the University of North Carolina School of Medicine, the home institution.
    Affiliations
    Emory University School of Medicine (JN Yarnall), Atlanta, Ga

    Children's Healthcare of Atlanta (JN Yarnall), Atlanta, Ga
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  • Carl Seashore
    Affiliations
    University of North Carolina School of Medicine (C Seashore, JE Hatch, C Hart, and JA Lohr), Chapel Hill, NC

    UNC Health – Children's (C Seashore, C Hart), Chapel Hill, NC
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  • Carrie A. Phillipi
    Affiliations
    Oregon Health & Science University (CA Phillipi), Portland, Ore
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  • Joseph E. Hatch
    Affiliations
    University of North Carolina School of Medicine (C Seashore, JE Hatch, C Hart, and JA Lohr), Chapel Hill, NC
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  • Beth King
    Affiliations
    Academic Pediatric Association (B King), McLean, Va
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  • Chayla Hart
    Affiliations
    University of North Carolina School of Medicine (C Seashore, JE Hatch, C Hart, and JA Lohr), Chapel Hill, NC

    UNC Health – Children's (C Seashore, C Hart), Chapel Hill, NC
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  • Author Footnotes
    ⁎ A complete list of study group members appears in the Acknowledgments.
    Jacob A. Lohr
    Footnotes
    ⁎ A complete list of study group members appears in the Acknowledgments.
    Affiliations
    University of North Carolina School of Medicine (C Seashore, JE Hatch, C Hart, and JA Lohr), Chapel Hill, NC
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  • on behalf of theVaccine Preferences Study Group
    Author Footnotes
    ⁎ A complete list of study group members appears in the Acknowledgments.
  • Author Footnotes
    1 Previously affiliated with the University of North Carolina School of Medicine, the home institution.
    ⁎ A complete list of study group members appears in the Acknowledgments.
Published:November 05, 2021DOI:https://doi.org/10.1016/j.acap.2021.10.004

      Abstract

      Objective

      Decreased childhood vaccination can lead to local outbreaks of vaccine-preventable disease. In a pilot study from our group, 72% of parents of newborns reported initiating their vaccine decision-making for that child prior to conception. Since a sound understanding of the timing of parental vaccine decision-making is needed to direct educational efforts, we surveyed a national cohort of first-time parents to extend our preliminary findings.

      Methods

      From March 2019 to March 2020, first-time parents of newborns in mother-baby units of the Better Outcomes through Research for Newborns (BORN) network completed the Vaccine Preference Development Survey (VPDS). The VPDS measures intent to vaccinate, timing of vaccine decision-making, and sources of influence. Univariate and multivariate analyses explored associations between intent to vaccinate and timing of vaccine decision-making with demographic variables.

      Results

      Twenty-three sites provided surveys through site-specific nonrandom systemic sampling; 91% (1393/1524) of surveys were used in the analysis. Most parents planned to fully vaccinate (1191/1380, 86.3%) and started vaccine decision-making prior to conception (850/1378, 61.7%). Maternal age, race and ethnicity, relationship status, and education were all significantly associated with planning to fully vaccinate and preconception decision-making (P < .001). Preconception decision-making correlated strongly with intent to fully vaccinate (P < .001). Parents influenced by personal education, medical professionals, and family/friends were more likely to endorse preconception decision-making; those strongly influenced by internet/social media were less likely to allow all vaccines or start decision-making prior to conception.

      Conclusions

      Vaccine decision-making occurs preconception for most new parents. Initiating vaccine discussions during the birth hospitalization may be too late.

      Keywords

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