"If they tell me to get it, I'll get it. If they don't ... ": Immunization decision-making processes of immigrant mothers

OBJECTIVE: To understand information-gathering and decision-making processes of immigrant mothers for scheduled childhood vaccines, vaccination during pregnancy, seasonal flu and pandemic vaccination. METHODS: We conducted 23 qualitative semi-structured interviews with immigrated mothers from Bhutanese refugee, South Asian and Chinese communities. Participants lived in Edmonton, Alberta and had at least one child under eight years old. Using NVivo (TM) qualitative software, we generated an inductive coding scheme through content analysis of interview transcripts. RESULTS: Our three main findings on information gathering and use in vaccination decisions were: 1) participants in all three communities passively received immunization information. Most mothers learned about vaccine practices exclusively from health care practitioners during scheduled visits. Social networks were primary sources of information in origin countries but were lost during immigration to Canada; 2) participants demonstrated universal trust in vaccines (i.e., no anti-vaccination sentiment). They were comfortable in receiving vaccines for themselves and their children, regardless of past adverse reactions; 3) participants' recollection of the H1N1 vaccination campaign was almost nil, demonstrating the lack of reach of public health vaccination campaigns to designated priority groups (pregnant women and children) in Alberta. CONCLUSION: Our results highlight the limitations of Alberta's current vaccination communication strategies in reaching immigrant women. When immigrant mothers receive vaccination information, our results indicate they will likely follow recommendations. However, our study shows that current communication strategies are not making this information accessible to immigrant women, which limits their ability to make informed vaccination decisions for themselves and their children.