Cordelia Ross and Leah H. Carr
Reviewed by Dr. William V. Raszka, MD
1. Opinions of partners and spouses were better predictors of vaccination decisions than other sources of vaccination information.
2. The proportion of people in the parent’s social network recommending nonconformity was most predictive of their vaccination decisions.
Evidence Rating Level: 2 (Good)
Study Rundown: Parents often rely on “people networks,” composed of friends, family, and healthcare providers, along with “source networks,” including books and the internet, for information and guidance when making decisions regarding their children’s’ vaccinations. Results from this social network analysis study indicated that parents who choose not to strictly follow vaccination recommendations were more likely to use “source networks” than those who conform to recommendations. Nonconformers also had significantly higher proportions of “people network” members who recommended non-conformity. One limitation of the study was that the study participants were not randomly sampled and therefore may not be representative of the population at large. Also, data collection relied on retrospective network data, which may have introduced recall bias. Nonetheless, findings from this study suggest that parents’ social networks are essential to their vaccine decision-making and that interventions for increasing vaccine acceptance should include these broader communities.
Relevant Reading: Parental decision-making in childhood vaccination
Study Author, Dr. Emily K. Brunson, MPH, PhD, talks to 2 Minute Medicine: Department of Anthropology, Texas State University, San Marcos, Texas.
“Parents do not exist in vacuums. Their opinions of and decisions about various health related issues, including vaccination, are the result of their previous life experiences as well as their interactions with their social networks (including the people these parents go to for information, direction and advice and the sources, like books and the Internet, they consult). My study used social network analysis to answer 2 questions: What are the people and source networks of parents like in relation to their vaccination decision-making? Do these networks influence parents’ vaccination decisions? The results of this research showed that significant differences exist between the people and source networks of parents who decided to conform to the recommended vaccination schedule and those who did not. In terms of parents’ vaccination decisions, this research also found that parents’ people networks were highly influential. In fact, the variable most predictive of parents’ vaccination decisions was the percent of their people networks recommending not conforming to the vaccination schedule.”
In-Depth [retrospective cohort study]: This study used social network analysis to examine the influence of other people and informational sources on parents’ vaccination decisions. 196 first-time parents participated in an online survey; 126 conformed to recommended vaccination scheduling and 70 were nonconformers who chose to delay vaccinations, partially vaccinate, or not vaccinate at all. Both conformers and nonconformers reported having a “people network,” with spouses and partners rated as the most important individuals in these networks. Also, both conformers and non-conformers indicated that health care providers were among the top 5 network members in their “people networks.” However, nonconformers had a significantly greater percentage of network members recommending non-conformity (72% vs. 13%, p < .001). Nonconformers were more likely to have unfavorable perceptions of vaccination, more likely to have a graduate degree, had significantly more “people network” members in general (mean of 6.7 vs. 4.8, p = .05), and had a significantly higher proportion of women in their “people networks” (71% vs. 65%, p = .05). In addition, “source networks” were more common among nonconformers than conformers (100% vs. 80%, p < .001), with more sources actively sought out (39% vs. 26%, p = .05) and books, rather than the internet, identified as the most important vaccination information source.
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