Paterson · Vaccine 2018 · cross-sectional qualitative interview study · n=25 interviewees (138 survey respondents from 913 invited)

Reasons for non-vaccination: Parental vaccine hesitancy and the childhood influenza vaccination school pilot programme in England.

Cited 69 times in the scientific literature.

Level 4 - case-series / case-control

Cross-sectional qualitative interview study

PubMed 28818568 · doi:10.1016/j.vaccine.2017.08.016 · record verified 2026-08-31

What was done

A cross-sectional qualitative study conducted between February and July 2015 in West Yorkshire and Greater Manchester, England. 913 parents whose children were not vaccinated during school-based influenza pilot programmes were asked to provide reasons for non-vaccination and invited to be interviewed. 138 parents returned response forms, and semi-structured interviews were completed with 25 parents, with transcripts analyzed thematically in NVivo.

What was found

One-third of parents who returned response forms had actually vaccinated their child elsewhere, planned to do so, or did not vaccinate due to medical reasons (valid or perceived). Qualitative analysis of the 25 interviewees identified key drivers of non-vaccination: lack of conviction regarding the necessity of childhood flu vaccination, concerns regarding vaccine effectiveness and side effects, and faith-based objections regarding the presence of porcine gelatine.

Why it matters

Shows that school non-consent counts overestimate true vaccine refusal due to alternative vaccination routes or medical deferrals, while highlighting specific religious and risk-perception barriers that targeted public health messaging must address to improve uptake.

Limits

Response rate was very low (138/913 forms returned, ~15.1%), with only 25 parents interviewed, introducing severe self-selection and non-response bias. The study was restricted to two regions in England and cannot quantify the exact prevalence of these beliefs across the broader population.

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