Assistant Professor of Pediatrics Columbia University Medical Center Columbia University Irving Medical Center New York, New York, United States
Background: Vaccine hesitancy is a state of indecision and reluctance about vaccines due to a complex set of social, cultural, political, and/or personal factors. Little is known how vaccine hesitancy differs between English- and Spanish-speaking caregivers.
Objective: To understand caregiver attitudes and practices relating to vaccines and information sources among English and Spanish-speaking caregivers.
Design/Methods: A convenience sample of caregivers of children 0-60 months old were recruited to complete an anonymous bilingual survey at four academic-affiliated community health clinics in an underserved area in New York City. The survey included the Parent Attitudes About Childhood Vaccines survey (PACV), a validated 15-question tool that measures parental vaccine hesitancy and is available in English and Spanish, as well as other questions regarding vaccine information sources. Surveys were completed by caregivers on an iPad or on paper. PACV scores (0-100) were calculated based on a standardized scoring. One-way ANOVA and 2-tailed t-tests were used to compare PACV scores with demographic variables including age, sex, primary language, education, and marital status.
Results: Of the 70 caregivers completing the survey, 69% were English-speaking and 31% Spanish-speaking (Table 1). Mean PACV scores among English-speaking participants were significantly higher than Spanish-speaking participants (34.0 vs. 22.1; P=0.009). Among all participants, a majority had concerns that their child might have a serious vaccine side effect (63%), that vaccines are not safe (51%), or that a shot might not prevent disease (53%)(Figure 1). However, very few reported delaying (9%) or refusing (7%) vaccines for reasons other than illness or allergy, and almost all (95%) said that if they had another infant today, they would want him/her to get all the recommended shots. The most commonly reported sources of vaccine information were from their child’s doctors, family and friends, the internet, and local and state health departments (Figure 2). All respondents at least somewhat agreed that they could openly discuss concerns about vaccines with their child's doctor. Conclusion(s): We found higher vaccine hesitancy in English vs. Spanish-speaking caregivers. The majority of caregivers reported not delaying or refusing vaccines and would vaccinate future children. All said they received information discussing concerns about vaccines from their child’s doctor, underscoring the importance of clear and effective communication by providers about vaccination.
Table 1: Analysis of PACV score by Demographics
Authors/Institutions: Ashley B. Stephens, Columbia University Medical Center, New York, New York, United States; Avery Quirk, Columbia University Irving Medical Center, New York, New York, United States; Douglas J. Opel, University of Washington School of Medicine, Seattle, Washington, United States; Melissa S. Stockwell, Columbia University Irving Medical Center, New York, New York, United States