Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Impact of Vaccine Rates on Parental School Choice

Vaccine; 2018 Jul 16; Cataldi, Dempsey, et al

Both vaccine-hesitant and non-hesitant parents are willing to accept longer commute times to protect their children from vaccine-preventable diseases. This according to a recent study that assessed 1) predicted impact of vaccination rates on school/child care choice, (2) differences between vaccine hesitant and non-hesitant parents, and (3) differences by child’s age. In 2016, a cross-sectional email survey of Colorado mothers with children aged ≤12 years assessed value of vaccination rates in the context of school/child care choice. A willingness-to-pay framework measured preference for schools/child care with different vaccination rates using tradeoff with commute time. Researchers found:

  • Response rate was 42% (679/1,630).
  • 12% of respondents were vaccine-hesitant.
  • On a scale where 1 is “not important at all” and 4 is “very important,” parents rated the importance of vaccination rates at 3.08.
  • Respondents (including vaccine-hesitant respondents) would accept longer commutes to avoid schools/child care with lower vaccination rates.
  • Parents of child-care-age children were more likely to consider vaccination rates important.

Cataldi JR, Dempsey AF, Allison MA, O’Leary S. Impact of publicly available vaccination rates on parental school and child care choice. Vaccine. 2018;(36)30:4525-4531. doi:10.1016/j.vaccine.2018.06.013.


This is a thought-provoking study looking at the importance of school vaccination rates for parents choosing schools for their children. Unfortunately, the response rate was <50% so it is not clear if the population that responded is truly representative of the entire population. However, it is interesting that both vaccine-hesitant and non-hesitant parents considered vaccine rates to be very important and that both groups would be willing to commute longer in order to avoid schools with lower vaccination rates. It seems that even vaccine-hesitant parents want their children to be protected by attending schools with a lower risk of vaccine associated diseases.—Sarah Rawstron, MB, BS, FAAP, FIDSA; Pediatric Residency Program Director, The Brooklyn Hospital Center, NY; Clinical Associate Professor, Icahn School of Medicine, Mount Sinai, NY.