What Are Your Attitudes on Vaccinations for Infants and Children?

Question 1: How do you balance the overall risks and benefits of vaccinations that most infants and children receive in the U.S.?

Question 2: How do you feel about this statement: So long as a disease is rare where I live, my family and I should avoid getting vaccinated because of the risk of adverse reactions.

Question 3: How do you feel about this statement: Even though there's some risk of adverse reactions to vaccines, my family and I should be vaccinated, because if we aren't we put the health of others at risk.

Question 4: Currently, all 50 states have school immunization laws requiring that children receive vaccinations, although different states may have somewhat different requirements and potential religious or philosophical exemptions.

How do you feel about schools requiring vaccines?

Question 5: Parents should have sole decision-making power about immunizing their children, in contrast to external regulations or requirements.

Health Policy Survey 2010: Summary of Responses to Selected Questions

The Center for Risk and Crisis Management at the University of Oklahoma conducted a nationwide Internet survey in early February of 2010 that focused on public perceptions of vaccination risks and policy preferences. Survey respondents were randomly drawn from a panel of willing participants that is balanced to match the demographic characteristics of the US Census. A total of 1,213 respondents (who are adults, 18 years of age or older) voluntarily participated in the survey. This brief summary lists five key questions asked in the survey, and presents the responses by survey participants.

Perceived risks and benefits of vaccinations for infants and children

Question: "Using a scale from one to seven, where one means the risks of required vaccinations far outweigh its benefits, four means the risks and benefits are equally balanced, and seven means the benefits of required vaccinations far outweigh its risks, how do you rate the overall balance of the risks and benefits of required vaccinations for infants and children in the U.S.?"

Overall, the survey participants tended to believe that the benefits of vaccines far outweigh the risks. Sixty-seven percent believed the benefits were greater than the risks, while only 10% perceived the risks to exceed the benefits. The responses are shown in Figure 1.

Avoidance of vaccination

Survey participants were asked a series of questions about their preferences concerning vaccines. The statements were prefaced by the following: "Please respond to each of the following statements using a scale from one to seven, where one means strongly disagree and seven means strongly agree."

The wording was as follows: "As long as the disease is rare in my community, my family and I should avoid getting vaccinated because of the risk of adverse reactions." The survey participants generally disagreed, as shown in Figure 2.

Survey participants were also asked to agree or disagree that: "Even though there's some risk of adverse reactions to vaccines, my family and I should be vaccinated because if we aren't we put the health of others at risk." While most of those surveyed agreed, a significant fraction (20%) disagreed that they should be vaccinated to avoid putting the health of others at risk. These responses are shown in Figure 3.

Policy preferences regarding vaccine requirements for school entry

Survey participants were asked about their preferences concerning mandatory vaccine programs. First, they were informed that: "Currently, all 50 states have school immunization laws requiring that children receive vaccinations, although there are differences in what may be required in different states." Then supporting and opposing arguments were presented for mandatory vaccine programs, using the following statements:

"Some people support these vaccine requirements for school entry because they help ensure that most people are protected through immunization. Because infectious diseases spread among susceptible people (including those who have not been immunized and the small percentage of people for whom the vaccine was not fully effective), vaccination decreases the chance of infection and outbreaks of disease in schools and communities by reducing the number of unprotected people who may be infected and subsequently transmit the disease to others."

"Some people oppose these vaccine requirements for several reasons. They argue that risks of an adverse reaction to the vaccines, particularly in infants and young children, make it unreasonable for the government to require vaccines. Some argue that children should be exempted from the requirements when their parents believe that the vaccines are dangerous to their health. Others argue that children should be exempted when the vaccine conflicts with deeply held religious beliefs, or when the vaccine conflicts with the parents' personal beliefs or philosophy."

Following the arguments, the participant was asked for their view: "Considering both arguments and using a scale from one to seven where one means strongly oppose and seven means strongly support, how do you feel about vaccine requirements for school entry?"

There was strong support for the mandatory vaccination program. Seventy-eight percent generally supported mandatory vaccinations, while only 10% opposed them. The distribution of responses to this question is shown in Figure 4.

Who should decide?

Mandatory vaccine programs limit parental choice, and may raise objections of governmental intrusion into the domain of household decisions. We asked our respondents the following question concerning parental choice: "On a scale from one to seven, where one means strongly disagree and seven means strongly agree, how do you evaluate following statement: Parents, not the government, should make decisions about immunizing their children."

The survey participants were divided on this question, but the majority (59%) generally agreed that the decision should be left to parents rather than the government. The overall pattern of responses is shown in Figure 5.

For a more general discussion of the survey results, see the following report: Jenkins-Smith, Hank, Carol L Silva, and Geoboo Song (2010) Health Policy Survey 2010: A National Survey on Public Perceptions of Vaccination Risks and Policy Preferences. Center for Risk and Crisis Management, University of Oklahoma, Norman, OK.