BACKGROUND:

Immunization may now be undervalued because vaccines have largely eliminated the threat of serious infectious diseases in childhood. As the incidence of vaccine-preventable diseases has declined, concern about vaccine safety has increased. Significant erosion of public confidence in vaccine safety could lead to reduced immunization rates and a resurgence of vaccine-preventable diseases.

OBJECTIVE AND METHODS:

To assess parents' understanding of vaccine-preventable diseases, vaccines, immunization practices, and policies, we conducted a telephone survey in the United States with a nationally representative sample (n = 1600) of parents with children </=6 years of age, and expectant parents in April and May 1999.

RESULTS:

Eighty-seven percent of respondents deemed immunization an extremely important action that parents can take to keep their children well. Although respondents' overall rating of immunization safety was high, a substantial minority held important misconceptions. For example, 25% believed that their child's immune system could become weakened as a result of too many immunizations, and 23% believed that children get more immunizations than are good for them. Children's health care providers were cited as the most important source of information on immunizations.

CONCLUSIONS:

Although the majority of parents understand the benefits of immunization and support its use, many parents have important misconceptions that could erode their confidence in vaccines. A systematic educational effort addressing common misconceptions is needed to ensure informed immunization decision-making. Physicians, nurses, and other providers of primary care have a unique opportunity to educate parents because parents see them as the most important source of information about immunizations.vaccination, immunization, pediatric, safety, health beliefs.