Master's Project Title:

Parental Beliefs and Attitudes as Barriers to Childhood Immunization: A Critical Literature Review

MCH Student:

Erika Fuchs

Date of Defense:

December 22, 2008


Objectives: The objective of this critical literature review is to improve the understanding of parental beliefs and attitudes that act as barriers to childhood immunization in the United States.

Methods: A systematic literature search of studies identified in 5 electronic databases was performed. To be included in the review, studies had to meet the following criteria: (1) address/examine self-reported parental beliefs and/or attitudes with regard to currently recommended childhood immunizations; (2) report original data; (3) be written in the English language; (4) be published in a peer-reviewed journal; (5) be published after 1998; and (6) be conducted in the United States. Relevant abstracts and articles were selected and information was abstracted into a structured abstracting form using The Matrix Method (Garrard, 2007). Eighteen articles were included in the review.

Results: Three broad themes encompassing the beliefs and attitudes of non-vaccinating parents were identified, including: self-reported attitudes, perceived social support, and perceived consequences. All eighteen studies included information which fell into one or more of the three themes.

Conclusions: Further research on parental beliefs and attitudes regarding vaccination is necessary in order to design interventions appropriate for the population wary of vaccinating their children. Physicians or other health care providers may be best suited to address the beliefs and attitudes which inhibit some parents from vaccinating their children. Interventions and educational materials must be directed toward addressing misconceptions about vaccines and must provide clear information regarding the risks and benefits of vaccines, including the risks of vaccine-preventable illnesses.