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Public Health Nurs. 2008 Sep-Oct;25(5):401-8. doi: 10.1111/j.1525-1446.2008.00724.x.

Deciding to opt out of childhood vaccination mandates.

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Denton County Health Department, Denton, Texas, USA.



We explore the attitudes and beliefs of parents who consciously choose not to vaccinate their children and the ways in which these parents process information on the pros and cons of vaccines.


In-depth, semistructured interviews were conducted.


The study population consisted of 25 parents who do not vaccinate their children, identified through snowball and targeted sampling.


Participants were asked about their processes and actions when choosing not to vaccinate their children. Interviews were taped and transcribed, and the content was analyzed for emergent themes.


Two predominant themes emerged in our data: a desire to collect information on vaccines and trust issues with the medical community. Evidence of sophisticated data collection and information processing was a repeated theme in the interview data. Simultaneously, while participants placed a high value on scientific knowledge, they also expressed high levels of distrust of the medical community.


The challenge for public health is to balance scientific data with popular epidemiology and to maintain legitimacy. Understanding the differences in lay versus expert knowledge has implications for crafting health messages. How experts frame knowledge for consumption has an important impact on this group and their decision-making processes.

[Indexed for MEDLINE]

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