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.


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.


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.

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