Social Networks Linked to Vaccine Decisions

If your friends don't follow standard vaccine schedules, chances are you won't either. That's the conclusion of a study that surveyed 196 parents. All of them had children 18 months old or younger. They took online surveys that asked their opinions on vaccines and what schedules they followed for their kids' shots. They also were asked about their sources of vaccine information and what the sources recommended. In all, 70 people skipped some recommended shots for their children, or delayed some of them. Researchers called this group "nonconformers." They tended to ask more people for advice than conformers (those who followed standard schedules) did. About 72% of the nonconformers' advice networks recommended skipping or delaying vaccines. Only 13% of the conformers' networks gave this advice. Networks included spouses, doctors, other health professionals, friends, family and work colleagues. Most people also had other information sources. These included books, pamphlets and the Internet. However, the study showed that people had a stronger influence on decisions than other sources did. The journal Pediatrics published the study online. HealthDay News wrote about it April 15.

By Claire McCarthy, M.D.
Harvard Medical School

What Is the Doctor's Reaction?

When it comes to making decisions about vaccines for children, parents listen to their friends.

This is understandable, of course. Part of the reason we choose our friends is that we value their opinions about things. But the problem is that friends don't always have the best information. That's especially true when it comes to medical subjects such as vaccination.

Pediatrics, the journal of the American Academy of Pediatrics, just published a study about vaccines and social networks. The study was done in King County, Washington.

Researchers asked first-time parents of children less than 18 months old to fill out online questionnaires. They asked the parents which people and which other sources they looked to when they were making decisions about vaccines. The parents then ranked those sources. Parents also were asked about their current vaccination decisions and what they thought about vaccines and vaccine-preventable diseases.

Here's what the study found: What most predicted the parents' vaccination decisions was the percentage of people in their social networks who recommended either not giving vaccines or giving them on a different schedule. If their friends gave vaccines according to the schedule doctors recommend, the surveyed parents most likely did, too. If their friends didn't follow the schedule, they were more likely not to as well.

The researchers called parents who didn't follow doctors' vaccine advice "nonconformers." It's interesting that these parents had more people in their networks than those who did follow doctors' advice.

What Changes Can I Make Now?

All parents should do three important things:

• Get informed about vaccines. The thoughts and opinions of your friends are important. But it's also important that you get information from the most medically complete and up-to-date sources. The one I recommend most is the Centers for Disease Control and Prevention (CDC). The CDC vaccination website has everything you might want to know about vaccines and vaccine-preventable diseases.
• If you have any questions or concerns about vaccines, talk to your doctor. Sometimes people feel intimidated, or they think the doctor might be upset if they question vaccines. But your doctor is there to help you. That includes helping you with your questions and concerns.
• If you think that vaccines are a good idea, and your children are immunized, spread the word! The anti-vaccine community tends to be more vocal than the pro-vaccine community. This contributes to low vaccination rates. So speak up! Talk about why you've made the decisions you've made, and about your experience with vaccination. It's particularly important to talk to prospective parents -- friends who are pregnant or thinking about getting pregnant -- so that you can help influence their decisions.

What Can I Expect Looking to the Future?

We have been seeing outbreaks of diseases, such as measles and pertussis, that vaccines can prevent. Sometimes the results have been deadly.

That's one of the very real problems with hesitating to get vaccines. When children who are not immunized get sick, they endanger other children. Particularly at risk are children who can't get vaccines. They may be too young to get vaccinated (pertussis can be deadly for newborns, for example) or may have a medical problem that prevents it. When people choose not to vaccinate their children, they are putting other children at risk as well.

This study tells us that if we want to encourage people to immunize their children, it's not enough to have doctors and health organizations lead the effort. Other parents -- and grandparents and day care providers and neighbors and community members -- need to help too.

It takes a village to raise a child, they say. It may just take the village to get children immunized, too.