Table 3.

Representative Quotes

Forming Vaccine Intentions
Responding to overwhelming and conflicting information
Individual research and commitment to making an “informed decision”	“I typically question myself: why do I think this, why do I believe this, and then find research or information about why that sort of backs up my…gives me evidence to support what I’m saying. And also sort of provides counter points of view for anything that’s opposing.” (Interview 4) “I did my own research: I looked at, sort of, what’s in the vaccinations they were given. I looked at the various active ingredients. I looked at, kind of, the literature, the scientific literature that’s out there that talks about various things that can go wrong.” (Interview 12)
Making decisions from a rational, scientific perspective	“It seems like all of their decisions, political decisions are based on fear and so it’s a hot topic for me…I don’t want to make a decision just because I’m afraid of what the outcome may be or… without doing proper research and making an informed decision I guess. That’s really important to me to make an informed decision instead of just an anecdotal or fear based decision.” (Interview 21) “I think in terms of deciding whether or not to vaccinate, it’s important to gather information, but to sort of, more important than getting the information, is to understand the source of the information and you know, it’s a medical decision. It’s not an emotional decision. So you need to make a decision that’s based in science and medical fact, not in, you know, what you’re feeling or what other people are feeling.” (Interview 5)
Overwhelming and conflicting information; ambiguity when interpreting information	“Yeah, I think people are just concerned. There’s a lot out there. There’s almost too much information… So it was hard for me to decide what I should really be doing…I just felt like I couldn’t make heads or tails of all the information I had.” (Interview 2) “There’s just a lot of information about there about the side effects of vaccinations and I wasn’t a crazy parent where I went and read about it all.” (Interview 9) “I guess until they really disprove that all and they can explain why there’s such a high rate [of autism] and what the causes are, then there will always be some kind of concern that vaccinations will be linked to autism.” (Interview 3) “I don’t know where to find the right answer. I feel like nobody seems to really have the answer. I don’t feel that doctors really know, because if they do, are they giving all the information? Because then why are there all these books out here that say, you know, that they do need to [re]schedule, you know, these things…or even changing some of the compounds that they use to make them. You know, I just think there’s a lot of unknowns.” (Interview 7) “I found myself talking about it, and thinking about it, and reading about it so much that I learned a lot about how vaccines in general get developed and how the information gets distributed and how people chose to understand, you know, what they’re hearing about it. And so, um, I mean it was interesting, like the same article that I read and five other people read could have been interpreted differently.” (Interview 5). “There are no easy answers at this point and there are people who put information out there, whether it be about diet or vaccines or anything else that isn’t really scientifically-based…but people are, of course, looking for answers and wanting to know what happened to their child, or why did this happen, or is there a potential answer. So I think a lot of the information is misleading, too, in that regard.” (Interview 11)
Tension between “science-based” and “non-science-based” decision-making
Too many vaccines at once	“I just staggered, so at least I knew her immune system wasn’t getting pummeled all at the same time.” (Interview 2) “But you know, they say they have these vaccines, [which] cause serious diseases. So at this point I just decided she didn’t need them all at the same time. (Interview 2) “And then given that [my son] was right off the bat stuck with 1,000 needles, I also felt a little bad for him. So I thought, alright, let’s give him a little break on that one.” (Interview 11) “I just think that if there’s any little chance that your brain has this hyper-inflammatory response because you’ve given five or six vaccines, that maybe we can just spread them out a little bit more.” (Interview 6)
Cost-benefit analysis and side effects	“I was very unsure about most of the vaccines. But most of them I felt like, I don’t know is she going to get the whooping cough? Like how bad would it be?” (Interview 2).
Gut reactions and fear	“You’re programmed now to be scared of potential autism and all these other things that could affect your baby.…You can take a little bit of information from one and a little from another, but I think that’s the lesson in parenting, is that you really just have to go with your gut and take what information you want” (Interview 7). “I didn’t really think him having multiple shots would really do anything bad to him. I think it was just we’re around some people who chose not to vaccinate because vaccines are going to cause problems. I think it’s just sort of in the back of your mind. What it he gets all of these shots and something bad happens? I think it was just a hesitation, sort of in the back. It never has changed my behavior in any such way.” (Interview 1)
Implementing Intentions
Delaying or spacing out vaccines as a response to vaccine doubts
Non-science-based decisions to delay vaccines	“It’s nothing scientific, I just felt like it’s a very little guy. You’re giving them, and they have to digest all of this, and especially with the MMR… They get a little bit of a fever, so I thought, alright let’s have him deal with one thing and…you know I asked them, which ones of these are tougher on the kid…so let’s do that one by itself” (Interview 11). “I probably would have followed an alternate schedule if it had been an option just ‘cause I think spacing them out I think, like I said before and there’s no, and this is a crazy decision I guess, there isn’t really evidence suggesting it is more healthy or less healthy but probably, I don’t know, in my mind it seems like a better idea to space them out.” (Interview 21)
Sympathy and tolerance for vaccine hesitancy
Perceptions of vaccine refusal	Disapproval “I think sometimes parents just need to hear it, just need to be like, ‘listen…I know you’re paranoid with stuff but this is what you need to be doing.’” (Interview 10) “I wrote down “crazy people” on my list because there’s just some people who are so strongly opposed to vaccination and…I don’t understand it.” (Interview 1) Tolerance “You know I don’t think they’re crazy….I would consider it more, maybe passionate or strong willed…they’re taking a stand that, in a minority against a majority. They don’t make these decisions lightly” (Interview 21). “[These are] people who look at the media and maybe don’t have the methods or the means to access the real literature or the real science to kind of check themselves.” (Interview 6) “Dangers associated with vaccinating your kids are really nonexistent, but I don’t blame people for thinking there’s something there that isn’t because there’s been so much misinformation and, you know the whole campaign against the MMR vaccine associated with autism and all of that. So because, you know, in the history of vaccines, there have been isolated events where there’s been something in the vaccine that has gotten some people sick. I understand as a parent that there are so many things that you have no control [over], so many bad things that can happen to your kid that you have no control over that you feel like, you know, vaccinating um, is something that you can control. But sadly some parents are making the wrong decision.” (Interview 5)
Perceptions of vaccine hesitancy and alternative schedules	“If you’re going to do your own vaccine schedule, which is fine, then you need to keep track of it.” (Interview 2) “I think the alternate schedule’s different than not vaccinating.” (Interview 6) “I’m still kind of dwelling on what kind of people give vaccines and don’t give vaccines and it’s hard to stereotype or label, I think, who does and who doesn’t because I think everybody has their own reasoning. And, you know, you wouldn’t want to judge as to why they would or wouldn’t, or label them as someone who would or wouldn’t, but, I think when it comes then to affect your child…that’s when it’s always hairy.” (Interview 7) “But in the end, like it makes you feel better, you’re still vaccinating your kid. I mean, I think it has to do with the parent, you know, at this point, whatever makes them feel better about everything.” (Interview 10) “It seems like [one of the arguments] for an alternative schedule, that I kind of do believe, is that it can’t be very healthy to have a whole bunch of things going into your body at the same time, a whole bunch of diseases. I’m sure you know, it’s been fine for [my son] and we followed a normal schedule but I can kind of understand that rationale. But I think it’s much more risky to not do it.” (Interview 21)