Document Type


Publication Date



School of Pharmacy


Pharmaceutical Systems and Policy


Background—Vaccine preventable diseases are making a comeback in the US. However, research is lacking on illness representations of vaccine preventable diseases and their application in improving childhood immunization. Objective—We utilized the common sense model of self-regulation to examine illness representations of pertussis and their associations with child’s receipt of any vaccine, up-to-date vaccination status, and mothers’ intentions to follow the recommended vaccination schedule in the future. Methods—We developed vaccine worry and vaccine hassles scales to assess mothers’ worries and hassles for child vaccination, and used an open ended question to assess mother’s illness representations of pertussis. We surveyed mothers with children (N = 160) in the Appalachian state of West Virginia, which only allows medical vaccine exemptions. Results—Some children (5.0%) had received no vaccination, 15.0% were not up-to-date with the recommended vaccination schedule, and 13.8% mothers reported no intention to follow the recommended schedule in future (future intention). Illness representations included identity (17.8%), timeline (61.8%), consequences (58.6%), cause (35.0%), and cure/control (56.7%). Higher vaccine worry was associated with child receiving no vaccine. Not using daycare, higher vaccine worry, and difficulty breathing (identity) were associated with child not being up-to-date. Higher vaccine worry, cough (identity), and belief that vaccines are ineffective (cure/control) were associated with no future intention.

Source Citation

Garg R, Meraya A, Murray PJ, Kelly K. Illness Representations of Pertussis and Predictors of Child Vaccination Among Mothers in a Strict Vaccination Exemption State. Maternal and Child Health Journal. 2017;22(1):137-146. doi:10.1007/s10995-017-2363-3