Abstract:
Understanding population perceptions of vaccine safety is crucial to maintain high vaccination coverage and prevent the outbreak of vaccine-preventable diseases. However, there is a lack of studies that assess vaccine safety perceptions in the unique context of New Zealand. The current thesis presents four studies that use data from a large, nationally representative survey to investigate group disparities and longitudinal changes in New Zealanders’ confidence in the safety of standard childhood vaccinations. Study one assessed disparities in vaccine safety perceptions among 11 different groups of health professionals. Although most General Practitioners (GPs) expressed strong confidence in vaccine safety, midwives and practitioners of alternative medicine showed substantially lower levels of strong confidence. Study two investigated ethnic disparities in perceptions of GPs and vaccine safety. Relative to minority ethnic groups, Europeans showed greater positive perceptions of GPs and confidence in vaccine safety. Key correlates of stronger confidence in vaccine safety, including the role of GP perceptions, were found to differ across ethnic groups. Study three examined the distinct influence of maternal and paternal confidence in vaccine safety on their children’s vaccination status. Mothers’, but not fathers’, level of confidence significantly predicted whether their children were fully vaccinated. Lastly, Study four assessed longitudinal changes in New Zealanders’ confidence in vaccine safety from 2013 to 2017. Three subpopulations with differing directions and trajectories of changes in level of confidence were identified. The demographic profiles of these distinct subpopulations were also investigated. This thesis provides crucial and novel insight into the level and shaping of New Zealanders’ confidence in childhood vaccine safety. They reveal high-risk groups more likely to exhibit low or decreasing confidence in vaccine safety and inform the development of tailored vaccination interventions for target groups.