Associations Between Prenatal and Childhood Vaccination Across Socioeconomic Statuses

Introduction: Vaccine-hesitant parents’ attitudes and behaviors result in refusal to vaccinate against some or all diseases (Wang, Clymer, Davis-Hayes, & Buttenheim, 2014), causing outbreaks of preventable diseases (Omer et al., 2008). Many outbreaks occur specifically in areas of a high socioeconomic status (Yang, Delamater, Leslie, & Mello, 2015). However, few studies have related prenatal and childhood vaccination to understand vaccination opinions and behavior (Fuchs, 2016). The current study explores how prenatal vaccination is associated with behavior and attitudes of childhood vaccination in mothers of different socioeconomic statuses.

Methods: Mothers aged 18-55 from outpatient medical offices (N=67) and Amazon Mechanical Turk (N=189) completed a survey (preliminary analyses showed no differences between groups). Participants answered questions regarding vaccination against the flu, both prenatally and for their child(ren). Respondents were also asked to state what information mothers relied on to inform themselves about vaccines and to what extent they trusted those sources of information in a survey measure modified from Frew et al., 2011).

Results: Mothers who received a flu shot prenatally were more likely to vaccinate their child against the flu, while mothers who did not receive a prenatal flu shot were less likely to get their child vaccinated, _x2 (1, N = 216) = 32.97, p < .01. Prenatal flu vaccination in a mother of any socioeconomic status resulted in 5x higher odds of childhood flu vaccination. High income parents were 3x more likely to vaccinate their children against the flu as compared to low income parents, and high socioeconomic status mothers showed more trust in credible vaccine sources, F (2, 219) = 5.16, p = .01. Finally, more favorable attitudes of vaccination predicted more vaccines received for mothers and children, R² = .24, F (1, 237) = 75.98, p < .01.

Conclusions: Based on the finding that mothers who received a prenatal flu shot were more likely to vaccinate their children against the flu, providers of prenatal care can play an integral role in promoting vaccination in mothers prenatally, affecting their postnatal decisions. By beginning the discussion about the importance of vaccines before children are born, collaboration between prenatal and pediatric care providers can improve childhood vaccination rates and allow mothers to rely on medical personnel as trusted sources for vaccine information.