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J Pediatr Health Care. 2009 Nov-Dec;23(6):388-93. doi: 10.1016/j.pedhc.2008.09.006. Epub 2008 Dec 19.

Parental hesitation as a factor in delayed childhood immunization.

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  • 1College of Nursing, Brigham Young University, Provo, UT 84602, USA.



One reason for lower immunization rates is that some parents hesitate to have their children immunized. A hesitancy questionnaire was developed to identify reasons parents hesitate in having their children immunized.


The hesitancy questionnaire was distributed from local pediatric and family practice offices and from the area's county health department. To be eligible, participants needed to be present in the clinic with a child needing a minimum of one immunization that was at least 6 months overdue.


When questioned why their child was overdue for immunizations, the most common response was that participants were confused about the immunization schedule and not sure when to return. Of the participants who reported having concerns regarding immunizations, the child's pain/crying/anxiety was the most commonly occurring answer. When asked where they receive the majority of childhood immunization information, participants frequently identified their health care provider as the main source of information.


Health care providers may be missing opportunities to educate hesitant parents about immunizations. Parents may not have ample opportunities to discuss their immunization concerns in detail with their health care provider during regularly scheduled clinic visits. It is important for health care providers to suggest ways parents can cope with their child's pain/crying/anxiety when receiving immunizations.

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