ArticleBMC pediatrics2009
Identification and characteristics of vaccine refusers.
Article in BMC pediatrics, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
45 citing papers in PubMed.
- Factors indicating intention to vaccinate with a COVID-19 vaccine among older U.S. adults.PloS one · 2021Trial
- Reasons for Childhood Vaccine Refusal: A Cross-Sectional Study in South-Eastern Türkiye.Children (Basel, Switzerland) · 2026Article
- Educational attainment and chronic HIV treatment adherence in southern and eastern Africa.PloS one · 2026Article
- Understanding COVID-19 vaccine hesitancy among older adults in post-zero-COVID China: a predictive modeling study.BMC geriatrics · 2025Article
- 'You don't need schooling-just take the pills and don't stop.': Pathways between formal education and chronic HIV care in Malawi.SSM. Qualitative research in health · 2025Article
- Strategies to correct vaccine misinformation on social media for pregnant women and the impact of vaccine skepticism.Scientific reports · 2025Article
- Is vaccine hesitancy related to mental health after the adjustment of the zero-COVID-19 strategy in the elderly? A mediation analysis in China.Human vaccines & immunotherapeutics · 2023Article
- Article
- Bibliometric and visual analysis of vaccination hesitancy research from 2013 to 2022.Human vaccines & immunotherapeutics · 2023Review
- The Role of Perceived Risk in the Relationship Between Disgust Sensitivity and COVID-19 Vaccine Hesitancy.Cognitive therapy and research · 2023Article
- Spatial distribution and determinants of childhood vaccination refusal in the United States.Vaccine · 2023Article
- Factors Associated with Vaccination Uptake among Young Children: A Follow-Up Study of 1799 Toddlers.Vaccines · 2023Article
- Scientific Misinformation and Mistrust of COVID-19 Preventive Measures among the UK Population: A Pilot Study.Vaccines · 2023Article
- Assessing vaccine hesitancy using the WHO scale for caregivers of children under 3 years old in China.Frontiers in public health · 2023Article
- Socioeconomic Inequalities and Vaccine Uptake: An Umbrella Review Protocol.International journal of environmental research and public health · 2022Article
- HPV vaccination and factors influencing vaccine uptake among people of Indian ancestry living in the United States.Epidemiology and infection · 2022Article
- Political views and science literacy as indicators of vaccine confidence and COVID-19 concern.Journal of preventive medicine and hygiene · 2022Article
- Self-Reported COVID-19 Vaccine Hesitancy and Willingness to Pay: A Cross-Sectional Survey in Thailand.Vaccines · 2022Article
- Decision making processes underlying avoidance of mandatory child vaccination in Croatia - a qualitative study.Current psychology (New Brunswick, N.J.) · 2022Article
- COVID-19 vaccination coverage by company size and the effects of workplace vaccination program in Japan: a cohort study.Environmental health and preventive medicine · 2022Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundThis study evaluated the utility of immunization registries in identifying vaccine refusals among children. Among refusers, we studied their socioeconomic characteristics and health care utilization patterns.
methodsMedical records were reviewed to validate refusal status in the immunization registries of two health plans. Racial, education, and income characteristics of children claiming refusal were collected based on the census tract of each child. Health care utilization was identified using both electronic medical record and insurance claims. Within the immunization registries of two HMOs in the study, some providers use refusal and medical contraindication interchangeably, and some providers tend to always use "ever refusal." Therefore, we combined medical contraindication and refusal together and treated them all as "refusal" in this study.
resultsThe immunization registry, compared to chart review, had negative predictive values of 85-92% and 90-97% for 2- and 6-year olds, and positive predictive values of only 52-74% and 59-62% to identify vaccine refusals. Refusers were more likely to reside in well-educated, higher income areas than non-refusers. Refusers had not opted out of health care system and continued, although less frequently for the age 2 and under group, to use services.
conclusionWithout enhancements to immunization registries, identifying children with immunization refusal would be time consuming. Since communities where refusers live are well educated, interventions should target these communities to communicate vaccine adverse events and consequences of vaccine preventable diseases.
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