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Vaccine hesitancy and reported non-vaccination in an Irish pediatric outpatient population

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posted on 11.11.2021, 11:44 authored by Sean O Whelan, Frank MoriartyFrank Moriarty, Lisa Lawlor, Kathleen M Gorman, Joanne Beamish
Vaccine hesitancy is defined as a delay in acceptance, or refusal, of vaccines, despite availability. It is a complex and context specific phenomenon and identified as a global health priority. The “Parent Attitudes about Childhood Vaccines” (PACV) questionnaire is a validated tool for identifying vaccine hesitancy. Our aim was to use the PACV to assess vaccine hesitancy and its relationship with reported non-vaccination in an Irish population, for the first time. Our participants were parents or caregivers of children attending general pediatric clinics in a tertiary pediatric hospital in Dublin, Ireland, between September and December 2018. In total, 436 participants completed the questionnaire. 5.5% of our population reported non-vaccination. Human papilloma virus and measles, mumps, rubella vaccines were the most commonly cited vaccines of concern (11.5% and 6.7%, respectively), and autism spectrum disorder was the most commonly side effect of concern (4.3%). Mean PACV score was 26.9 (SD 19.1), with a significant difference between non-vaccinators and vaccinators (53.2 vs 25.3, p<0.001). Safety and efficacy concerns were the major contributor to non-vaccination. 14.4% of our population were vaccine-hesitant using the conventional cut-off score, which increased to 22% when using an optimal cut-off which maximized sensitivity and specificity. The accuracy of the PACV score to identify non-vaccination was good (area under the ROC curve = 0.827), and the optimal cut-off had a high negative predictive value (98.5%).
Conclusion: PACV identified reported non-vaccination with high accuracy in our population. It may be useful to screen vaccine-hesitant parents who could benefit from interventions to improve uptake.
What is Known:
• Vaccine hesitancy is a leading threat to global health, with falls in vaccine uptake associated with disease outbreaks worldwide.
• The Parent Attitudes about Childhood Vaccines (PACV) questionnaire is a validated measure of vaccine hesitancy and correlates with non-vaccination in many populations.
What is New:
• This large study in a pediatric outpatient clinic setting represents the first use of the PACV in a Western European population to assess vaccination hesitancy.
• The PACV may be an effective way of screening a pediatric clinic population to identify vaccine-hesitant parents or caregivers for targeted vaccine promotion.



The original article is available at https://link.springer.com

Published Citation

Whelan SO, Moriarty F, Lawlor L, Gorman KM, Beamish J. Vaccine hesitancy and reported non-vaccination in an Irish pediatric outpatient population. Eur J Pediatr. 2021;180(9):2839-2847.

Publication Date

27 March 2021

PubMed ID



  • School of Pharmacy and Biomolecular Sciences

Research Area

  • Population Health and Health Services


Springer Science and Business Media LLC


  • Accepted Version (Postprint)