Parents’ Varied Concerns About Vaccines Should Be Addressed

Several studies have attempted to define the reasons why parents are vaccine hesitant, and the most common factors are:
44% of parents reported concern over pain associated with receiving multiple injections during a single visit
34% expressed unease about receiving too many vaccines at a single visit
26% worried about the development of autism or other potential learning difficulties after receiving vaccines, 13.5% expressed concern that vaccines could lead to chronic illnesses
13.2% stated that vaccines were not tested enough for safety before their use
One survey found that parents who decide to not vaccinate their children have a greater distrust of health care professionals and the government and are more likely to use complementary and alternative medicine, compared with parents who vaccinate their children.
Most of the surveyed parents agreed that vaccines protected their children from diseases; however, more than half expressed concerns regarding serious adverse effects of vaccines. Overall, 11.5% of parents in that study had refused at least 1 recommended vaccine, and the fear that vaccines could cause autism was often cited as a reason for refusal.
Parental concerns must be addressed, and concerns will vary among parents. For example, vaccine safety and triggering early sexual activity are often cited as parental concerns about the HPV vaccine. Some parents are concerned primarily about the pain associated with immunizations.
Nurses should use strategies to reduce pain include administering vaccines quickly without aspirating, holding the child upright, administering the most painful vaccine last, and providing tactile stimulation. Breastfeeding, feeding sweet-tasting solutions, and topical anesthetics are other tools that can be used before vaccine administration to decrease pain. Distraction strategies, including pinwheels, deep breathing exercises, and toys, can be used in older children to decrease anxiety and pain. Although rigorously controlled studies of these techniques have not been performed, studies of other painful procedures lend support to their use in vaccination.
The production and composition of the vaccines as far as, concerns about the presence of mercury (thimerosal) in vaccines, parents can be reassured that currently, none of the single-dose vaccine preparations given to infants contain any mercury. The opposition to the presence of aluminum as an adjuvant in some vaccines is not an issue as there is strong evidence for both the necessity of the aluminum for a vigorous immune response and there is a lack of evidence for its toxicity. The religious argument that vaccines contain cells derived from aborted human fetuses has been answered in statements from major religious denominations acknowledging that the vaccines do not contain such cells.
A specific response to the parental concern of “too many vaccines” and the potential for “overwhelming the immune system” was provided by Offit et al. As shown in Table 3, the number of immunogenic proteins and polysaccharides contained in currently licensed vaccines is significantly smaller than the number of antigens contained in earlier vaccines and in naturally circulating organisms that infected children before universal vaccination.