Autonomy and Control among Parents Who do not Comply with Recommended Pediatric Vaccinations: A Qualitative Case Study

Objective: To identify the main reasons why parents decided not to vaccinate their children according to the official recommendations. Methods: A qualitative descriptive study approach was used, including 12 in-depth interviews with parents of two-year-old children who refused to vaccinate their children. Data were analyzed in three stages: open coding, mapping analysis and focused analysis. Results: Five main themes emerged: Parents demand the right to make decisions regarding their child's vaccinations autonomously; they wish to take responsibility and be in control of their child's health; they perceive their actions (refusal) as characteristic of "good parenting"; they are critical of and distrust the medical establishment; and they base their decision on a calculation of the risks of the vaccines vs. the risk of the disease. Any combination of these factors may reflect the reasons for not complying with recommended pediatric vaccinations. Conclusion: Parents' decisions whether, when and how to vaccinate cannot be ascribed to one single reason or cause; rather, it is a combination of interrelated factors. Understanding this complex phenomenon may help professionals plan interventions, to prevent a decline in vaccine coverage rates.