Date of Award

Winter 2004

Project Type


Program or Major


Degree Name

Doctor of Philosophy

First Advisor

Heather A Turner


Within recent years, a group of parents who question or oppose vaccination has emerged in the United States. While recently receiving attention within medicine and public health, parental questioning of and resistance to childhood immunization is a trend that has yet to be examined within sociology. This dissertation explores the role of parental characteristics, beliefs, and attitudes on resistance to pediatric immunization.

Thirty-five in-depth interviews with parents who postponed or refused vaccinations for their children were conducted. Qualitative data were used to develop a survey instrument including a series of scales measuring parental beliefs and attitudes about pediatric vaccination. The survey was administered via telephone to a random sample of 310 parents with children aged thirteen or under. Data describing the prevalence of vaccine questioning in the United States and the relationships between race/ethnicity, socioeconomic status, and mistrust and risk beliefs on parental questioning and refusal of vaccination are presented.

In addition, I provide an explanatory framework for vaccine questioning within the theoretical orientation of risk theories of modernity. I develop and test a conceptual model that examines the effects of risk assessment and engagement, mistrust or skepticism of expert systems of knowledge, alternative medical orientation, social support, social status variables, and vaccine questioning and concern on parental vaccine practices. The dependent variable is a four category variable that incorporates both vaccine behaviors and perception of pressure to vaccinate.

Multinomial logistic regression results indicate that parental risk awareness, risk mastery, mistrust of science and medicine, and vaccine concerns are each significantly related to vaccine uptake behaviors. Results also show a conditional association between education and vaccine concerns. The positive effect of vaccine concerns on the odds of pressured vaccine acceptance and pressured vaccine postponement/refusal was significantly greater among respondents with higher education. There is similar evidence of a conditional association between minority status and vaccine concerns. Vaccine concerns increase the odds of pressured postponement-refusal and pressured acceptance more so among white respondents than among minority respondents. Public health and sociological implications of these findings are discussed.