Addressing issues of vaccination literacy and psychological empowerment in the measles-mumps- XXXX (MMR) vaccination decision-making: a qualitative study.

@entity1 @entity2462 @entity102
BACKGROUND: Whether or not to vaccinate one's @entity1 is one of the first health-related decisions parents have to make after their @entity1 's birth. For the past 20 years, the share of parents choosing not to immunize their @entity1 has increased in many countries, for various reasons. Among these, rumors affirming that vaccinations contain dangerous chemicals or might trigger severe @entity102 have negatively affected parental attitudes towards pediatric immunizations, particularly the vaccination against measles, mumps and @entity2462 (MMR), raising a number of public health concerns. The primary aim of this qualitative study is to understand what drives parents' decision, giving special attention to vaccination literacy and psychological empowerment in such a context. METHODS: Twenty individual semi-structured interviews were conducted in the Canton of Ticino (Switzerland) between January and June 2014. @entity1 were either mothers or fathers of @entity1 less than 1 year old living in Switzerland. An inductive thematic analysis was performed to identify the main themes with regard to vaccination literacy and psychological empowerment in the MMR vaccination decision-making. RESULTS: Parents' reports yielded four main themes: (a) the paradox of the free choice, referring to the misinterpretation of current vaccination policies; (b) giving up the power, pointing at the outcomes of a low perceived competence; (c) a far-reaching decision, reflecting the importance attributed to the MMR choice and the different levels of impact the decision can have; (d) the demand for shared-decision making, referring to the parental needs in relation to the @entity1 's healthcare provider. CONCLUSION: Understanding what drives parents' management of their @entity1 's immunization schedule in terms of vaccination literacy and psychological empowerment can help health professionals to communicate more effectively with parents in order to facilitate an informed decision, and stakeholders to design tailored health education programs and materials. This can ultimately help increase the coverage of the MMR vaccination.
