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Utah's Foremost Platform for Undergraduate Research Presentation
2021 Abstracts

Why Parents Say No to Having Their Children Vaccinated Against Measles: A Systematic Review

Presenters: Mallory Showalter, College of Life Sciences, Public Health
Authors: Mallory Showalter, L. Kirsten Novilla, Katelyn Aldridge, Tyler Leffler
Faculty Advisors: M. Lelinneth Novilla, College of Life Sciences, Public Health
Institution: Brigham Young University

Background: Ongoing outbreaks of measles threaten its elimination in the United States. While national and state immunization coverages remain high, the resurgence of measles points to local pockets of under-vaccination that coincide with lower parental vaccine confidence and higher non-medical exemptions. The reported geographic clustering of vaccine hesitancy, particularly against MMR, points to social drivers that shape parental perceptions and decisions on immunization. Objectives: To determine the: 1) reasons why parents refuse or delay MMR vaccination; 2) social context of MMR vaccine hesitancy; 3) perceived reliable sources of vaccine information between vaccine-hesitant and vaccine-compliant parents/guardians; 4) role of families in countering vaccine hesitancy; and 5) public health, primary care, and government vaccination strategies. Methods: A systematic review of seven databases (Web of Sciences; Scopus; Medline/PubMed; Embase; CINAHL; PsycINFO; and Proquest) yielded 421 unique scholarly articles on vaccine hesitancy published since 1999, which were narrowed down to 73 articles. Results: Parents feared vaccine ingredients more than the diseases that vaccines prevent. Pain, adverse reactions, and multiple vaccines per visit were among the reasons why parents say no to vaccines. Misleading information linking autism to the MMR vaccine sowed fear among parents resulting in either refusal or delay in measles immunization. Vaccine-hesitant parents clustered in middle-income or affluent areas, most with a college education or higher, and preferred internet vaccine narratives over physician-based information. Despite containing approaches on parental communication, message framing, patient-physician discussion, the literature lacked family-centered approaches to vaccine hesitancy. Conclusions: Vaccine hesitancy ranged from total to selective rejection of certain vaccines such as the MMR vaccine. Vaccine hesitancy is common in under-vaccinated communities that serve as hotspots for transmission. Building parental trust and addressing the gaps in family-centered approaches may counter the social determinants that influence parental assent.