Vaccination Choice Influenced by Social Networks

Lara C. Pullen, PhD

Apr 15, 2013

Parents make vaccination decisions largely based on their social networks. In particular, nonconformity recommendations (recommendations not to vaccinate) within the social network were more predictive of vaccination decisions than parents' own perceptions of vaccinations.

Emily K. Brunson, PhD, MPH, from Texas State University in San Marcos, presented the results of her survey in an article published online April 15 in Pediatrics. Dr. Brunson surveyed United States–born, first-time parents who had children aged 18 months or younger and resided in King County, Washington. A total of 126 participants conformed to vaccination recommendations and 70 did not.

In both groups, 95% or more of parents reported having "people networks" (people that they go to for information). Nonconformers, however, were significantly more likely to report "source networks" (sources parents go to for information and advice; 100% versus 80%; P < .001).

Parents undergo a complex process when deciding whether or not to immunize their children. Research in the 1950s first demonstrated how strong social influence can be in guiding personal judgement.

The current study connects immunization decision-making with the pressure to conform to group opinion and explores whether parents choose a social group that reflects their belief and actions or, rather, let their social group dictate their beliefs and actions. Dr. Brunson's data suggest that the social groups dictate the decisions.

The study also allows for the likelihood that social networks sustain and strengthen a vaccination decision. The study reinforces the theory that healthcare decisions in general, and vaccination decisions in particular, are made within a social context.

"Although the provider-parent conversation about vaccines may be the most influential to parent decision-making, these conversations can be difficult to navigate, especially during the increasingly time-limited provider-parent encounter," write Douglas J. Opel, MD, MPH, and Edgar K. Marcuse, MD, MPH, both from the University of Washington in Seattle, in an accompanying editorial. "Public health interventions aimed at shaping the social milieu of immunization decision-making outside the examination room can complement providers' efforts to achieve the full benefit of immunizations within. Our emerging understanding of vaccine decision-making suggests that this priming of the pump is just what is needed."

The author and editorialists have disclosed no relevant financial relationships.