Parents support daycare policies to get kids up-to-date on vaccines

November 17, 2014 Volume 22 Issue 4
  • Three-quarters of parents think daycare providers should check vaccination records every year.
  • Two-thirds of parents think they should be informed of the number of children at the daycare center who are not up-to date on vaccines.
  • 41% of parents support a policy to exclude undervaccinated kids from daycare until they become up-to-date.

Almost all states require vaccines for children who attend daycare, to prevent the spread of disease. However, even with requirements, some children do not receive all vaccines. In June 2014, we asked a national sample of parents of children 0-5 about vaccination policies for children in daycare.

How Do Parents Feel about Daycare Vaccination Policies?

Most parents agree that all children in daycare centers should be vaccinated (59% strongly agree, 22% agree), with slightly less agreement for children in home-based childcare (47% strongly agree, 24% agree). In addition, most parents feel that daycare providers should review children’s immunization status every year to ensure they are up-to-date (52% strongly agree, 22% agree).

Most parents (66%) think they should be informed of the number of children at their daycare center who are not up-to-date on vaccines. Only 25% of parents believe they should receive the names of children who are not up-to-date on vaccines.

In a scenario where 1 in 4 children in their daycare center were not up-to-date with vaccinations, 74% of parents would consider removing their own children from that childcare center; another 11% would consider removal of their children only if an outbreak occurred.

With regard to how daycare centers should deal with a child who is not up-to-date on vaccines, parents most commonly support excluding the child until all vaccines are received (Figure 1). Only 1 in 10 parents support allowing an unvaccinated child to attend childcare, without a waiver or vaccine requirement.

Implications

Daycares are common settings for the spread of disease, due to the close proximity of young children. Vaccination is an effective way to prevent outbreaks of serious diseases such as pertussis, chicken pox, and influenza, and protects children in daycare who are too young to be fully vaccinated themselves with all recommended doses. In addition, vaccination of young children prevents the spread of diseases to family members of all ages who are immunocompromised, such as people with cancer or those taking medicines that affect their immune systems.

Results of this poll indicate that most parents support daycare policies requiring children to be up-to-date on vaccines. This support is consistent with existing daycare vaccination requirements in every state.  However, some state requirements apply only to daycare entry, which may discount the importance of keeping children up-to-date on vaccines. Poll results show that three-quarters of parents feel daycares should check vaccination records every year; in practice, this may not be done consistently.

Even with daycare policies or state requirements, parents may seek medical, religious, or philosophical exemptions to vaccination, which means that some children in daycare may not receive all vaccines. Poll results on how to handle this situation demonstrate mixed views among parents. The most common area of agreement is the belief that parents should be informed of how many children in the daycare are not up-to-date on vaccines, but not the names of those children. 

Parents had varying responses to how the daycare should respond in a situation where a child is not up-to-date on vaccines. The majority of parents in this poll felt the daycare should insist the child be vaccinated—with a split between those who felt the child should be excluded until vaccination occurred and those who felt the family should have a grace period while the child continues to attend daycare. Few parents felt the child should be allowed to attend daycare without any expectations that either vaccines or a waiver from a doctor would be obtained. 

Parents in this poll also had mixed responses to a hypothetical situation where 25% of children in a daycare were not-up-to-date on vaccines. Although the majority said they would consider removing their child from that daycare, the responses varied from “definitely would consider” to “only in the event of an outbreak”. It seems that parents do not have a consensus threshold in this arena.

The take-home message from this poll is that, when choosing a daycare for their child, parents should feel comfortable asking about the vaccination policies, such as whether the daycare excludes children who are not up-to-date, and whether they check children’s vaccination status every year.

Data Source:

This report presents findings from a nationally representative household survey conducted exclusively by GfK Custom Research, LLC (GfK), for C.S. Mott Children’s Hospital via a method used in many published studies. The survey was administered in June 2014 to a randomly selected, stratified group of adults age 18 and older from GfK’s web-enabled KnowledgePanel® that closely resembles the U.S. population. Responses from parents with a child 0-5 (n=614) were used for this report. The sample was subsequently weighted to reflect population figures from the Census Bureau. The survey completion rate was 53% among the parent panel members contacted to participate. The margin of error is ± 3 to 5 percentage points.

C.S. Mott Children’s Hospital National Poll on Children’s Health
Director: Matthew M. Davis, MD, MAPP
Associate Director: Sarah J. Clark, MPH
Manager & Editor: Dianne C. Singer, MPH
Data Analysts: Amilcar Matos-Moreno, MPH & Acham Gebremariam, MS
Web Editor: Anna Daly Kauffman, BA
Research Associate: Katrease Hale, MPH

Findings from the C.S. Mott Children's Hospital National Poll on Children's Health do not represent the opinions of the investigators or the opinions of the University of Michigan. The University of Michigan reserves all rights over this material.

 

SURVEY QUESTIONS FOR PARENTS AND GRANDPARENTS WITH A CHILD AGE 0-11 IN PUBLIC OR PRIVATE SCHOOL.

Q1. Thinking about children age 0-5 years, before they start full-day school, please rate your agreement with the following.

  Strongly Agree Agree Neutral Disagree Strongly Disagree
All children in childcare centers should be required to be up-to-date on vaccines.          
All children in home-based childcare should be required to be up-to-date on vaccines.          
Childcare providers should be required to check the vaccine status of every child, every year, to make sure they stay up-to-date.          


Q2. Imagine that you are the parent or grandparent of a 1-year-old child who goes to a childcare center.  Please rate your agreement with the following.
I should be able to find out…

  Strongly Agree Agree Neutral Disagree Strongly Disagree
The number of children who are not up-to-date on vaccines.          
The names of the children who are not up-to-date on vaccines.          

Q3. If you knew that 25% of children (1 in 4) were not up-to-date on vaccines, would you consider taking your child out of that childcare center?

  • Definitely would consider
  • Possibly would consider
  • Would not consider
  • Would consider only in the event of an outbreak

Q4. What policy would you support for a child who is not up-to-date on vaccines?

  • Keep child out of childcare until they get vaccinated 
  • Give parents a grace period to get child vaccinated 
  • Require parents to get a waiver from the child’s doctor 
  • Allow child to attend childcare with no penalty 
  • Other: [TEXT BOX] 

All information is the sole property of the University of Michigan C.S. Mott Children's Hospital National Poll on Children's Health. It can only be used if there is an acknowledgment that "The information came from, is copyright by and is owned by and belongs to the Regents of the University of Michigan and their C.S. Mott Children's Hospital National Poll on Children's Health. It cannot be republished or used in any format without prior written permission from the University."

C.S. Mott Children’s Hospital National Poll on Children’s Health
Director: Matthew M. Davis, MD, MAPP
Associate Director: Sarah J. Clark, MPH
Manager & Editor: Dianne C. Singer, MPH
Data Analysts: Amilcar Matos-Moreno, MPH & Acham Gebremariam, MS
Web Editor: Anna Daly Kauffman, BA
Research Associate: Katrease Hale, MPH

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Figure 1: Parent preferred daycare policies for children not up-to-date on vaccines

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