Abstract: Examining Conversations Between Parents and Children About Childhood Vaccinations

◆ Robyn B. Adams, Michigan State University
◆ Fashina Aladé, Michigan State University
◆ Morgan Ellithorpe, Michigan State University

Background: Low childhood vaccination rates in the U.S. are associated with outbreaks of serious preventable diseases (Phadke et al., 2016). While some parents choose not to have their child receive any vaccinations, there are also understudied groups who choose to have their child receive some but not all of the recommended vaccinations or to receive the vaccinations on a delayed schedule. Children themselves sometimes play a role in the health decisions parents make on their behalves. There is little documented research on the communication that happens between parents and children about vaccinations and their influence on parents’ decisions. Therefore, the objective of this study was to qualitatively explore parents’ conversations with their children about vaccinations and to examine how these conversations may differ by vaccination status to inform research on potential differences between those who fully vaccinate their children and those who do not.

Methods: This mixed-method study is part of a larger survey of a national sample of 779 parents with at least one child under 18 (72% female, Mage=38, 70% Caucasian), recruited through Dynata’s opt-in panel. We oversampled participants who reported deviating from the CDC recommended vaccination schedule, resulting in a final sample of 420 full, 134 delayed, 103 partial, and 122 non-vaccinators. Parents were asked whether they had ever talked with their child about vaccinations (closed-ended: yes or no) and then asked to describe the most memorable conversation they’ve had with their child about vaccinations (open-ended).

Analysis & Results: Most participants reported talking to their children about vaccinations: none (~55%), partial (65%), delayed (72%), full (67%). To analyze the 376 open-ended responses, the first two authors utilized a grounded theory approach to discover emerging themes, and coded responses for theme presence/absence. Inter-coder reliability >α=.79 was established on 30% of responses with disagreements resolved via discussion. The following themes were most prevalent in parent-child discussions: 1) Keep child healthy, 2) Prevent serious illness/death, 3) Comfort child, and 4) Vaccines are harmful/dangerous. Full vaccinators reported talking to their children most about how vaccines would keep them healthy (75%), prevent serious illness (71%), and about comforting their child (78.5%). Comparing delayed to partial vaccinators, partial vaccinators more often mentioned keeping their child healthy in a general sense (11.9% vs 10%), while delayed vaccinators more often specifically mentioned preventing serious illness or death (17.3% vs 9.6%); both groups were similar in reporting comforting their child during the conversation (~14%). Interestingly, partial vaccinators were similar to non-vaccinators in talking to their child about how vaccines could cause serious risks/dangers (33% and 38%, respectively).

Conclusions: This study explored the conversations parents and children have about vaccinations. Parents across all vaccine groups share similar conversational themes, however, some patterns differ between vaccination groups. Understanding how conversations between parents and children may influence – and be influenced by – vaccination status may help to inform research on the mindsets of parents surrounding vaccination and identify intervention points to encourage vaccine compliance.