Maternal Attitudes and Other Factors Associated with Infant Vaccination Status in the United States, 2011-2014

the Study of Attitudes and Factors Effecting Infant Care (SAFE) study, Baylor University Medical Center, TX, Baystate Medical Center, MA, Ben Taub General Hospital, TX, Bethesda Memorial Hospital, FL, Brookdale Hospital and Medical Center, NY, Camden Clark Medical Center, WV, Delaware County Memorial Hospital, PA, Geisinger Regional Medical Center, PA, Genesys Regional Medical Center, MI, Hamilton Medical Center, GA, Jersey Shore University Medical Center, NJ, Johns Hopkins Hospital and Medical Center, MD, Kaweah Delta Health Care District, CA, Lake Charles Memorial Hospital, LA, Medical Center of Arlington, TX, Moreno Valley Community Hospital, CA, Mount Carmel, OH, Natchitoches Regional medical Center, LA, Nashville General Hospital, TNNorthcrest Medical Center, TN, Riverside County Regional Medical Center, CA, Riverside Regional Medical Center, VA, Rush-Copley Medical Center, IL, Saint Francis Hospital and Medical Center, CT, Saint Joseph Hospital, CA, Saint Mary's Health Care, MI, Socorro General Hospital, NM, Sutter Roseville Medical Center, CA, Tacoma General Hospital, WA, Texas Health Presbyterian Hospital, Plano, TX, University of California, Davis Medical Center, CA, Wheaton Franciscan Healthcare, WI

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Objective To assess the role of maternal attitudes and other factors associated with infant vaccination status. Study design Data on reported vaccination status were analyzed from a nationally representative prospective survey of mothers of 2- to 6-month-old infants. Weighted univariate and multiple logistic regression analyses were conducted. Latent profile analysis of mothers reporting nonimmunized infants identified distinct groups, Results Of 3268 mothers, 2820 (weighted 86.2%), 311 (9.1%), and 137 (4.7%), respectively, reported their infant had received all, some, or no recommended vaccinations for age. Younger infants and infants with younger mothers were more likely to have received no vaccinations. Mothers with neutral and negative attitudes toward vaccination were >3 (aOR 3.66, 95% CI 1.80-7.46) and 43 times (aOR 43.23, 95% CI 20.28-92.16), respectively, more likely than mothers with positive attitudes to report their infants had received no vaccinations. Two subgroups of mothers reporting that their infants had received no vaccinations were identified: group A (52.5%) had less than positive attitudes and less than positive subjective norms about vaccination (ie, perceived social pressure from others); group B (47.5%) had positive attitudes and positive subjective norms. Group A mothers were more likely to be white (76.1% vs 48.3%, P =.002), more educated (43.5% vs 35.4% college or higher, P =.02), and to exclusively breastfeed (74.9% vs. 27.3%, P <.001). Conclusions Although access barriers can result in nonvaccination, less than positive maternal attitude toward vaccination was the strongest predictor. Strategies to improve vaccination rates must focus on both improved access and better understanding of factors underlying maternal attitudes.

Original languageEnglish
Pages (from-to)136-142.e1
JournalJournal of Pediatrics
StatePublished - Jun 2017


  • vaccination


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