I am a medical research professional and am currently trying to gather research to publish a paper about the reasons some parents are opting NOT to immunize their child. I am not attempting to make any judgments or use the information I obtain to condemn parents; this is simply an informational survey.
I would very much appreciate your assistance in this endeavor. The survey questions are below. The answers need not be long, and please only answer those questions you feel comfortable addressing.
Thanks for your help,
Monica Milleson, Omaha, NE
For parents who have not vaccinated* their child for at least one of the diseases listed below please answer the following:
Diphtheria (Can be prevented by the DTaP vaccine)
Haemophilus influenzae type b (Can be prevented by the Hib vaccine)
Hepatitis A (Can be prevented by the HepA vaccine)
Hepatitis B (Can be prevented by the HepB vaccine)
Influenza (Can be prevented by the annual flu vaccine)
Measles (Can be prevented by the MMR vaccine)
Mumps (Can be prevented by the MMR vaccine)
Pertussis (Whooping Cough) (Can be prevented by the MMR vaccine)
Pneumococcal Disease (Can be prevented by PCV vaccine)
Polio (Can be prevented by the IPV vaccine)
Rotavirus (Can be prevented by the RV vaccine)
Rubella (German Measles) (Can be prevented by the MMR vaccine)
Tetanus (Lockjaw) (Can be prevented by the DTaP vaccine)
Varicella (Chickenpox) (Can be prevented by the Varicella vaccine)
*Immunizations for Persons Aged Birth Through 6 Years Old recommended by the Centers for Disease Control and Prevention, the American Academy of Pediatrics, and the American Academy of Family Physicians
1. Which of the above has your child NOT been vaccinated for?
2. Please indicate the specific reasons why you did not vaccinate your child for each of the diseases you listed in the previous questions?
3. Did you discuss your concerns and reasons for not vaccinating your child with your healthcare provider? If so, what was their response?
4. Are you, the parent, or legal guardian, vaccinated for any diseases?
5. Do you believe your child is at risk for contracting any of the diseases he or she was not vaccinated for? If so, what concerns, if any, do you have about your child contracting one of the diseases prevented by the vaccines?
6. What sources of information did you use in making your decisions regarding vaccinating your child?
7. If a healthcare provider was source of information used to make your decision, do you felt they provided you adequate information about the vaccination and its potential side effects?
8. Did you healthcare provider pressure you to have your child vaccinated?
9. Did you feel judged by your healthcare provider when refusing a vaccination for your child?
10. Have you, or anyone that you know personally, been adversely affected after a vaccination?
9. Is your child home-schooled? If so, did you choose to home-school your child because they are not vaccinated, or for other reasons?
10. Does your child attend any of the following: day-care, public school private school? If so, did you use an exemption to enroll your child into the facility? What exemption did you use and why?
11. Does your have access to healthcare insurance? If so, does your child have a private insurance carrier, Medicaid, or other type of provider that covers childhood vaccinations?
12. Do you have any regrets or concerns about your decision?