Parents’ Source of Vaccine Information and Impact on Vaccine Attitudes, Beliefs, and Nonmedical Exemptions

In recent years, use of the Internet to obtain vaccine information has increased. Historical data are necessary to evaluate current vaccine information seeking trends in context. Between 2002 and 2003, surveys were mailed to 1,630 parents of fully vaccinated children and 815 parents of children with at least one vaccine exemption; 56.1% responded. Respondents were asked about their vaccine information sources, perceptions of these sources accuracy, and their beliefs about vaccination. Parents who did not view their child’s healthcare provider as a reliable vaccine information source were more likely to obtain vaccine information using the Internet. Parents who were younger, more highly educated, and opposed to school immunization requirements were more likely than their counterparts to use the Internet for vaccine information. Compared to parents who did not use the Internet for vaccine information, those who sought vaccine information on the Internet were more likely to have lower perceptions of vaccine safety (adjusted odds ratio (aOR), 1.66; 95% CI, 1.18–2.35), vaccine effectiveness (aOR, 1.83; 95% CI, 1.32–2.53), and disease susceptibility (aOR, 2.08; 95% CI, 1.49–2.90) and were more likely to have a child with a nonmedical exemption (aOR 3.53, 95% CI, 2.61–4.76). These findings provide context to interpret recent vaccine information seeking research. 1. Introduction High coverage of recommended vaccines in the United States has resulted in a reduction in incidence of greater than 99% for many vaccine-preventable diseases [1–3]. These high immunization coverage levels [4] are due, in large part, to school immunization requirements [5]. While immunization coverage is at or near record highs [6], vaccine refusal rates have increased in states that readily allow nonmedical exemptions to school immunization requirements [7]. Additionally, vaccine refusal is often clustered geographically which has been associated with outbreaks of disease [8]. Increasing exemption rates and the potential for reemergence of vaccine-preventable diseases in the United States highlight the need to effectively communicate accurate information on vaccination to parents. The most common source of vaccine information is primary healthcare providers, but research has shown that parents obtain vaccine information from a multitude of other sources as well [9]. The Internet has rapidly become a widely used source of information, including information on vaccines. While Internet use for information seeking is ubiquitous now, it was a common source of health-related information