Children who aren't vaccinated face harsher judgment than their parents who refused immunization, says a study examining attitudes involving a contentious public health issue for which Canada lacks a national vaccination strategy.
Other kids may not want to sit next to unvaccinated students at school, work on projects with them or go on a play date at the child's house, said Prof. Richard Carpiano, lead study author and a sociologist at the University of British Columbia.
Children of so-called anti-vaxxers deal with more stigma regardless of the reasons for their parents' decision, Carpiano said of the study that focused on mothers because they typically make a family's health decisions.
Some parents don't want their children vaccinated based on long-debunked fears that vaccines cause autism, mercury poisoning or auto-immune disorders.
"Child vaccination is a complex problem that poses significant health consequences for the child and the community," said the study published this month in the journal Social Science and Medicine.
It said public health efforts to address the issue require an understanding of parents' motives and how the general public interprets them because of concerns about the high risk of unvaccinated or under-vaccinated kids spreading infectious diseases, such as measles, mumps and whooping cough.
The study was based on data collected from a July 2015 online survey of 1,469 U.S. respondents, though Carpiano said the results are just as applicable in Canada.
Respondents were randomly assigned to read one of four scenarios. They included a mother who refused to vaccinate her child, another who delayed immunization over safety concerns, while a third mother's job and family demands left no time for medical appointments, and a fourth, who represented a control group, ensured her child received the recommended vaccinations.
"People may be more likely to blame and express anger toward parents who intentionally choose to refuse or delay vaccinations for their children, but more likely to express sympathy for a parent who encounters barriers to accessing vaccinations," sometimes due to lack of medical services in their area, the study says, adding children face discrimination regardless of the reasons they were not vaccinated.
Survey respondents with the strongest reactions were more likely to support policies such as parents being notified about vaccination rates at their child's school or kids being banned from school until they're up to date with immunizations, Carpiano said.
"When I tell people I study this I get some very energetic reactions, to put it kindly," he said. "People immediately say, `Oh, those crazy people,' or 'Those people are nuts.' It's hitting at a dear-held value about health, about child welfare, about parenting and more broadly, about community."
Carpiano said policy-makers should focus vaccination messages on parents who delay immunization, often as they seek information, rather than on the small but vocal minority of "anti-vaxxers."
Immunization rates in Canada vary among provinces but the issue is complex because there is no national plan that monitors rates, which are believed to be as low as 85 per cent but should be closer to 95 per cent, he said.
In Ontario, for example, students whose vaccination records aren't up to date can be suspended from school for up to 20 days under the Immunization of School Pupils Act.
That was the case in December 2015, when Ottawa Public Health suspended 900 elementary students after 5,000 notices of suspension were sent to parents.
The issue prompted Ontario's health minister to say the province will require parents to attend education sessions if they choose not to vaccinate their kids and put others at risk.