Despite the fact that 1 in 3 clinicians have seen no change in parental acceptance of childhood vaccinations in the past year, a new report from Medscape suggests an increase in parents’ agreeing to have their children immunized.
The 2016 Medscape Vaccine Acceptance Report surveyed more than 1,500 pediatricians, family medicine physicians, public health physicians, nurse practitioners, and physician assistants to gain insights into clinician perceptions about the current levels of vaccine acceptance, refusal, and requests to delay the vaccine schedule from parents.
This year, 46% of clinicians reported more acceptance of vaccines overall in their practice. Only 12% of clinicians reported less vaccine acceptance than the year before. However, clinicians did report that many parents remain reluctant to vaccinate their children for some diseases like HPV, which 61% cited as the most frequently refused or delayed vaccination, followed by influenza (39%) and MMR (37%). Acceptance for the MMR vaccine did increase by 15 points over 2015.
“Despite changes in policy, the availability of information, and significantly greater awareness about the risks associated with vaccine refusal, the modest increase in acceptance we saw this year suggests that work still needs to be done to improve vaccination acceptance,” said Hansa Bhargava, MD, pediatric editor for Medscape and WebMD. “While there is no one solution, it’s important that clinicians pro-actively address parental concerns while educating their patients about the fact that vaccines not only help keep their family safe, but they also protect others by making diseases less likely to spread.”
Reasons for Refusal, Motivators for Acceptance
When asked to identify the reasons for refusing or delaying vaccines, more than half of all clinicians who noted less vaccine acceptance reported parental fears of adverse events, concerns about added ingredients in vaccines, and fear of overwhelming a child’s immune system with too many vaccines. The reasons clinicians cited for parents’ refusal or delay of the HPV vaccine included a lack of concern about the risk of their child contracting a sexually transmitted disease (71%), and the view that the vaccine promotes sexual activity (46%).
Still, the clinicians who reported an increase in vaccine acceptance overall this year cited a number of key factors, including a growing concern among the majority of parents (72%) about the increased outbreaks of infectious diseases and denial of admission to school, daycare, or camp (44%). More than half of all clinicians (and 74% of pediatricians) believe that state laws should be passed or made stronger that mandate certain vaccinations and remove exemptions for school admission.
The Impact of the Provider-Parent Relationship
Clinicians recognize their pivotal role in encouraging vaccine acceptance, and they employ a variety of approaches to educate parents and address specific concerns. The report found that clinicians most often use evidence-based information to educate their patients about the benefits of vaccinations, as well as to correct misinformation or misunderstandings about the potential risks.
However, in the case of the HPV vaccine, the report revealed that despite evidence-based information about the benefits, 7% of clinicians indicated that they remain ambivalent about the vaccine, and as a result, don’t promote it as strongly as other vaccines. Other research has shown that this provider hesitancy may contribute to high rates of refusal of the HPV vaccine. Nationwide, only 40% of girls and 21% of boys receive the recommended three doses of HPV vaccine. The vaccine is recommended for pre-teen girls and boys beginning at age 11 or 12.
Despite the risks associated with refusing or delaying vaccinations, the vast majority of respondents (90%) said they continue to allow these parents and their children to remain with their practice. This approach is consistent with guidelines from The American Academy of Pediatrics, which recommends against dismissing families that refuse vaccines from the practice, based on the belief that future visits offer opportunities for continued parental education. While this approach holds promise, risks remain. According to respondents, 82% make no modification in office procedures to prevent other children from contracting vaccine-preventable diseases.
The 2016 Medscape Vaccine Acceptance Report was completed by 1,551 health care professionals (505 family medicine physicians, 505 pediatricians, 38 public health physicians, 328 nurse practitioners, and 175 physician assistants) from May 8, 2016, to May 31, 2016. The margin of error for the survey was +/- 2.49% at a 95% confidence level.