Control of vaccine-preventable diseases in children depends on compliance with the immunization schedule recommended by the Centers for Disease Control and Prevention (CDC), but compliance
becomes more challenging as new vaccines are recommended. The success of the immunization program may result in some parental complacency regarding the potentially debilitating or fatal consequences of vaccine-preventable diseases [1]. This misperception
combined with inaccurate information about vaccine safety,
has led to vaccine-hesitancy among some parents and the evolution
of communities where the majority of parents seek exemptions
from immunization [2–5] rendering their communities vulnerable
to outbreaks of vaccine-preventable diseases (VPD) [5–9]. It is estimated
that as many as 85% of providers encounter parental refusal
of some vaccines annually [10]. Vaccine safety is the prominent
concern [10,11], but parental demographics, family knowledge and
attitudes about vaccines, the number of vaccines recommended,
perception of disease risk, access to preventive healthcare, cost and
time constraints also likely have an effect