Vaccine-related attitudes and decision-making among uninsured, Latin American immigrant mothers of adolescent daughters: a qualitative study

Abstract

Uninsured Latin American immigrant women are at increased risk for vaccine preventable diseases, such as cervical cancer; yet gaps in vaccine coverage persist. The purpose of this study was to explore vaccine-related knowledge, attitudes and decision-making for tetanus, diphtheria, and acellular pertussis (Tdap) vaccine, meningococcal conjugate vaccine (MenACWY), and human papillomavirus (HPV) vaccine among uninsured Latin American immigrant mothers of adolescent daughters. A purposive sample of 30 low-income, uninsured, predominantly Latin-American immigrant mothers of adolescent daughters aged 13-17 were recruited from two academic-community managed health clinics in Virginia. From March-September 2016, data were collected through in-person, semi-structured interviews, in English or Spanish. For data analysis, conventional content analysis was employed. The majority of participants self-identified as Hispanic and had less than a high-school level education. Key themes included: general acceptance of vaccines; associating vaccines with prevention/protection; minimal vaccine hesitancy; and lack of knowledge regarding vaccine-preventable diseases, vaccines recommended for adolescents, and adolescent daughters' vaccination history. Doctors' recommendation, school requirements, and the media were key influencers of vaccination. Mothers were the primary decision-maker regarding vaccine uptake among their adolescent daughters. Findings highlight the need for efforts to help uninsured Latin American immigrant mothers better understand vaccines, and provide linkages to affordable, accessible vaccines among under-resourced populations.

Knowledge, Attitudes and Perceptions of Immigrant Parents Towards Human Papillomavirus (HPV) Vaccination: A Systematic Review

“…Our systematic review revealed certain attitude-related barriers to vaccine acceptability for adolescents, particularly vaccine hesitancy among some mothers. A qualitative study reported that Latin American immigrant mothers of adolescent daughters expressed more hesitancy regarding adolescent vaccines compared to childhood vaccines expressed an increased sense of belief in their ability to determine what is best for their children [48]. In contrast to the negative attitudes of immigrant parents as found in most of the included studies in our systematic review, most mainstream non-immigrant women had positive attitudes about receiving an HPV vaccine and high intention to receive the vaccine both for themselves and their daughters [49].…”

The Factors That Promote Vaccine Hesitancy, Rejection, or Delay in Parents

“…(E. Wang et al, 2015, p. 6706) In 23 studies, parents described how they perceived that the risk of adverse side effects from vaccines to be higher than the risk of acquiring vaccine-preventable disease Blaisdell et al, 2016;Dubé et al, 2016;Enkel et al, 2018;Gullion et al, 2008;Harmsen et al, 2013;Hatoková et al, 2018;Koski & Holst, 2017;McCoy et al, 2019;P. McDonald et al, 2019;Meleo-Erwin et al, 2017;Painter et al, 2019;Peretti-Watel et al, 2019;Reich, 2014Reich, , 2018Senier, 2008;Sobo et al, 2016;Swaney & Burns, 2019;Vandenberg & Kulig, 2015;E. Wang et al, 2015;Ward et al, 2017Ward et al, , 2018.…”

“…This belief was conflated with three ideas. First, parents claimed that vaccine-preventable diseases were easily treatable Blaisdell et al, 2016;Painter et al, 2019;Sobo et al, 2016;Vandenberg & Kulig, 2015). Under this idea, parents believed that they were capable of identifying the symptoms of vaccine-preventable disease and administering treatment themselves Blaisdell et al, 2016;Harmsen et al, 2013;Reich, 2014;Ward et al, 2017).…”

“…Interestingly, parents in eight studies explained how vaccine hesitancy in their health care providers encouraged their own decision to refuse vaccines despite showing openness to full acceptance (Carrion, 2018;McCoy et al, 2019;P. McDonald et al, 2019;Meleo-Erwin et al, 2017;Painter et al, 2019;Peretti-Watel et al, 2019;Swaney & Burns, 2019;E. Wang et al, 2015):…”

“…Third, albeit parents viewed media campaigns and articles published on the internet that supported vaccines, they remained skeptical of these information sources Austvoll-Dahlgren & Helseth, 2010;Carrion, 2018;Dubé et al, 2016;Enkel et al, 2018;Gullion et al, 2008;Harmsen et al, 2013;Hatoková et al, 2018;Helps et al, 2019;Miller et al, 2008;Painter et al, 2019;Senier, 2008;Vandenberg & Kulig, 2015;Ward et al, 2017). For example, parents' interpretation of anecdotes from parenting blogs that opposed vaccines varied from skepticism to being swayed to not vaccinate (Helps et al, 2019;P.…”