Parents' role as advocates for and against childhood vaccination: Findings from a nationally representative survey.

Abstract

In 2025, the US recorded the highest number of measles cases in 25 years, signaling an urgent need for renewed attention to increasing childhood vaccination coverage. To identify future intervention partners, we sought to understand parents' role in advocating for and against childhood vaccines. A nationally representative sample of 1,315 parents of children ages 9-12 years participated in our online survey about vaccine advocacy behaviors in 2025. Separate weighted logistic regression models identified correlates of encouraging or discouraging other parents from getting routine vaccines for their children. Over one-third of parents reported encouraging routine vaccines sometimes or more often (36%), while about one-tenth reported discouraging vaccines (12%). These estimates include a small proportion of parents (6%) who reported both behaviors. Parents with higher confidence in the importance of vaccines for their child's health were more likely to be encouragers and less likely to be discouragers (both p < .05). Encouragers (n = 477) most often advocated for measles (50%) or seasonal flu vaccines (44%). These parents most often engaged family members and close friends, using strategies such as sharing vaccine experiences (47%), information about vaccine effectiveness (38%), and advice or opinions about vaccines (35%). Discouragers (n = 151) most often advocated against Covid-19 (53%) or seasonal flu vaccines (41%), with relatively few focusing on measles vaccine (10%). Discouragers engaged similar audiences and strategies as encouragers. Findings of our nationally representative study suggest that parents who encourage routine vaccination far outnumber those who discourage it. Given that encouragers often advocate for measles vaccine, future efforts to increase vaccination coverage should consider ways to partner with parent advocates to stem the alarming resurgence of this disease.