[Compliance and Resistance to Child Vaccination: a Study Among Swiss Mothers]

Background: This study examines mothers' practices and attitudes in relation to their child's immunization. In this area, like in others, gaps are being observed between the public health model of risk management and the population expectations and behaviors.

Methods: Data were collected using a standardized questionnaire from 1295 women having, in 1999, one child between 7 and 8 years of age of Swiss nationality and attending the public school system in Geneva.

Results: Four immunization types were established based on (1) the degree of satisfaction (in relation to past choices), (2) the perception of adequate knowledge about immunization and (3) practices. The mothers were divided into the following categories: compliant (57%), compliant ambivalent (19%), moderately resistant (17%) and resistant (7%). Mothers having reached an intermediate education level are more likely to be resistant. Furthermore, women having negative attitudes towards biomedical institutions, having consulted alternative practitioners and those considering that they have a certain individual control over the health of the family are more often resistant to immunization.

Conclusion: Our results confirm the existence of a resistance to child immunization among a section of the population. It should not be attributed to mothers' ignorance, but rather could reflect their perplexity towards the choices they are expected to make. In that regards, the importance some parents give to individual control over health can be in contradiction with community objectives of public health. Actions for the promotion of immunization should primarily target families who are uncertain (compliant ambivalent and moderately resistant). At the same time, the difficulties entailed in the - individual and collective - management of risks require that new forms of dialogue be developed between experts and the public.