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Introduction: The resurgence in cases of vaccine-preventable childhood diseases in the U.S. may be associated with increasing rates of vaccine hesitancy. Although previous research has sought to identify attributes of non-vaccinating parents, the timing in which parents make such vaccination decisions has yet to be explored. Our goal is to identify when first-time parents develop their vaccination preferences: before, after, or during pregnancy.

Methods: A cross sectional survey was conducted using a convenience sample of 73 first time parents at Thomas Jefferson University Hospital. Survey questions addressed timing of vaccination decisions and projected compliance with vaccine schedules. Eligibility for the study included delivery within 72 hours, newborn gestational age of at least 37 weeks, maternal age of at least 18 years, and primary language of English or Spanish. Statistical analysis included chi-squared test and descriptive statistics to compare vaccine hesitancy and timing of vaccination decisions.

Results: The pre-conception period was when most first time parents formed their vaccine preferences (n=45, 61%). The decision to give all vaccines was the highest, 84%, if their decision was made pre-conception. This proportion fell to 60% among those who made their decision during or after pregnancy (chi-square p-value 0.02).

Discussion: This study confirms that most first time parents develop their vaccination preferences before pregnancy. Pre-conception decisions were associated with decreased vaccine hesitancy, which indicates that distributing vaccine information to new families before they conceive may assist with achieving higher vaccination rates.