1 in 10 Parents Skip or Delay Vaccines

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More than one in 10 parents don’t follow the recommended vaccination schedule for their children, according to a new study. And one in four who do adhere to current guidelines say they still feel that it may not be the best or safest way to immunize youngsters.

Writing in the journal Pediatrics, Dr. Amanda Dempsey, a pediatrician at University of Michigan, and her colleagues unpack the often conflicting attitudes that parents have about vaccines. They polled a nationally representative sample of 748 parents, who were mostly in their 30s and 40s, and asked about whether they immunized their young children according to the recommendations laid out by the Centers for Disease Control and Prevention.

The CDC lays out specific age and dose schedules for vaccinating children against infectious disease like mumps, pertussis and measles. Thirteen percent of parents surveyed said did not follow the CDC’s guidelines, reporting that they skipped some or all vaccines; lengthened the recommended time between doses of certain immunizations; delayed some shots past the recommended age; and split up the measles, mumps, rubella (MMR) vaccine, receiving each part separately.

The vaccines that parents most often skipped were seasonal flu vaccine, the H1N1 flu vaccine and the chicken pox vaccine. Parents were lease likely to skip immunizations against polio and diphtheria-tetanus-acellular pertussis (DTaP).

The scientists also asked parents about their attitudes toward alternative schedules. Researchers expected a certain percentage of parents to adopt alternative schedules, but what surprised them was how conflicting or misguided parents’ views about vaccination could be — regardless of which vaccination schedule they followed.

For example, those who decided not to vaccinate their children against known vaccine-preventable disease, such as chicken pox, flu, mumps, measles and rubella, acknowledged that their decision could put other children in the community at risk of becoming infected, but they believed their own child would remain healthy. By failing to apply the increased risk to their own children, such parents exposed a blind spot in reasoning when it came to the health of their own families, the authors said.

Similarly, even parents who followed the CDC’s immunization guidelines said they had doubts about the safety of the schedule, with 22% reporting that they disagreed or strongly disagreed that the plan was the best one to follow. A similar percentage believed that delaying vaccines was also safer than currently recommended dosing plans.

“We were disturbed and somewhat surprised that parents who were following the regular [vaccination] schedule had a belief that made their likely future adherence to doses somewhat tenuous,” says Dempsey. “And we were somewhat surprised that 30% of those who followed the alternative plan had started out on the recommended plan.”

Prior to the study, child health experts had assumed that most parents who opted out of the current vaccination schedule had likely made that decision prior to the birth of their children, probably out of a pre-existing and deeply held belief about vaccine safety. But the study showed that many of such parents actually change their minds about vaccination, after initially following the government’s recommended schedule.

While the study didn’t investigate what triggered their shift in thinking, other research suggests that parents may become confused by the glut of information and misinformation that is currently available about immunization, which can influence their attitudes.

“One of the biggest problems with vaccines is that they are so effective in reducing vaccine preventable disease outbreaks, that most parents today don’t have any personal or even second or third level experience with these diseases and how devastating they can be,” says Dempsey. “Converse to that, a lot of parents today know people whose kids have autism, and because there have been questions raised about the association of vaccines to autism, people feel the risks of vaccination are worse than the risks of the disease they prevent, which isn’t the case.”

Driving much of the lingering skepticism over the safety of vaccines is the debunked claim by a disbarred British physician that the MMR vaccine could cause autism; that study was later discredited and retracted from its publishing journal for being fraudulent.

Also worrying parents is the fact that infants simply get so many vaccines in such a short period of time, when their still-developing immune systems may not be prepared to process them correctly. That shouldn’t be a concern, says Dempsey, since today’s inoculations contain a much smaller load of the bacterial and viral proteins that parents are worried about, compared with older immunizations. “What parents don’t understand is that the number of antigens, or proteins, that challenge the immune system is much less than what used to be given, when there were only a few vaccines in the schedule,” she says. “Parents are understandably counting the number of vaccines, and equating that with the number of antigens, but it’s actually the reverse — fewer antigens are being delivered than there used to be.”

As the new findings reveal, health care providers like Dempsey still face a formidable challenge in providing accurate information to concerned and often conflicted parents. One way to target their education efforts may involve parents without access to health care. More parents who did not have a regular physician to look after the health of their children opted for alternative vaccination schedules than parents who saw doctors regularly. It was unclear whether these parents were less likely to have health care contact because of their non-traditional attitudes about immunization, or vice versa, but focusing on parents who fall outside of the system may be a place to start.

“Vaccination is a complicated issue,” says Dempsey. “Parents make the decisions they feel are in the best interests of their child. There is no magic bullet that will suddenly change everybody’s mind about immunization. But there is some groundwork in developing interventions and educational outreach that might be useful to help more parents put their attitudes about them into a more realistic context.”

Alice Park is a writer at TIME. Find her on Twitter at @aliceparkny. You can also continue the discussion on TIME’s Facebook page and on Twitter at @TIME.

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