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Originally published by 2 Minute Medicine® (view original article). Reused on AccessMedicine with permission.

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1. Pregnant women who received discouraging information about vaccinations, regardless of whether or not they received encouraging information, were more likely to delay vaccination in their infants.

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2. Positive, encouraging information about vaccines was not tied to an increase in the timeliness of infant vaccinations.

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Evidence Rating Level: 2 (Good)

Study Rundown:

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Though previous studies have revealed that women make decisions about vaccinating their child during pregnancy, little was known about how the quality of information about vaccines affected women’s decisions. This study explored the effect of both encouraging and discouraging information about vaccines when given to expectant mothers during pregnancy. Women in the third trimester were asked whether they had received encouraging or discouraging information about vaccination and the sources of their information. Infants’ immunizations were subsequently tracked, with delayed status defined as vaccines given greater than 30 days after the recommended timeline. Though healthcare workers were the most common source of information, large portions of women still received information from family, friends, and the media, with the latter sources being more likely to provide mixed or only discouraging information. Results suggest that children of women who received either mixed or only discouraging information were more likely to have all their vaccines delayed. Additionally, receiving only encouraging information was not associated with an increased odds of following the recommended vaccine timeline. Though the study was novel in its exploration of the qualitative nature of vaccine education, it is limited by the inherent weaknesses of recall and participant interpretation. These findings may encourage physicians to educate not only individual patients, but also the public and media at large, about the critical role vaccines play in children’s health.

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Study author, Dr. Cameron Grant FRACP PhD, talks to 2 Minute Medicine: Head of Department, Paediatrics: Child & Youth Health; Professor in Paediatrics, The University of Auckland, New Zealand.

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“It is important to acknowledge that childhood immunization will always be a challenging issue for future parents. Professional conversations about infant immunization should begin before the child is born, and need to explore what information future mums and dads have already received about infant immunization.”

In-Depth [prospective cohort]:

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A total of 6182 women and 6205 infants were recruited and analyzed from a socioeconomically and ethnically diverse region of New Zealand. Interviews were done face-to-face with computer assistance, and women were given a myriad of options for the source of their information. Infant immunization status was tracked using the National Immunization Registry. New Zealand’s immunization guidelines at the time included 6-week, 3-month, and 5-month doses of a combination vaccine (consisting of DTaP, HiB, Hep B, and polio antigens) and the pneumococcal conjugate vaccine. Reported sources of information included: healthcare providers (35%); family and friends (14%); and media (14%). Of those receiving information from family and friends, 39% received only discouraging advice, while 11% received mixed information. Fifty-three percent of those receiving information from media sources received only discouraging information, while 18% received mixed. Children of women who had only received discouraging information were less likely to be vaccinated (OR = 0.49, 95% CI 0.38-0.64) and more likely to have delayed their vaccines (OR 2.61, 95% CI 1.87-3.59). Similar odds ratios were discovered for women receiving mixed information. There was no correlation between encouraging information and following vaccine guidelines.

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