---
title: "Caregiver political affiliation linked to childhood vaccine hesitancy but not fluoride opposition"
id: "pubmed-42418961"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42418961"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42418961/"
doi: "10.1016/j.vaccine.2026.128900"
published_at: "2026-08-30T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Caregiver political affiliation linked to childhood vaccine hesitancy but not fluoride opposition
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42418961
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42418961/)
- **DOI:** [10.1016/j.vaccine.2026.128900](https://doi.org/10.1016%2Fj.vaccine.2026.128900)
- **Published At:** 2026-08-30T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Study objective: assess whether caregiver **political affiliation** correlates with **childhood vaccine hesitancy**, opposition to **topical fluoride**, and opposition to **community water fluoridation (CWF)**. - Design and data collection: cross-sectional survey using an online REDCap questionnaire administered November 2020–September 2021 to caregivers at five university- or children’s hospital-based clinics in four U.S. states and via social media. Total collected surveys: 1,049; analyzed: 833. - Sample characteristics: caregivers were predominantly female (79.5%), mean age 41 years (SD = 8), highly educated (87.4% college degree or higher), with 36.0% reporting household income >$100,000. - Outcome prevalences: **childhood vaccine hesitancy** 40.9%; opposition to **topical fluoride** 37.2%; opposition to **CWF** 37.7%. - Primary analysis: confounder-adjusted logistic regression models examined associations between political affiliation and each prevention outcome. - Key results: conservative caregivers had significantly higher odds of **childhood vaccine hesitancy** compared with moderate and liberal caregivers (moderate: OR = 0.54, 95% CI 0.33–0.87; liberal: OR = 0.51, 95% CI 0.30–0.85). - Null findings: **political affiliation** was not significantly associated with opposition to **topical fluoride** or **community water fluoridation** (p-values > 0.05). - Conclusion: political affiliation showed a differential association with prevention attitudes—linked to vaccine hesitancy but not to fluoride opposition. - Conflict of interest: authors declared no competing financial interests or personal relationships. Details on additional limitations or subgroup analyses were not reported in the abstract.
## Clinical Analysis & Structured Key Points
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Epub 2026 Jul 8. # Caregiver political affiliation is associated with childhood vaccine hesitancy but not fluoride opposition [Ana Luiza Peres Baldiotti](https://pubmed.ncbi.nlm.nih.gov/?term=Baldiotti+ALP&cauthor_id=42418961)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42418961/#full-view-affiliation-1 "Department of Oral Health Sciences, School of Dentistry, University of Washington, Box 357475, B509 Health Sciences Building, Seattle, WA 98195-7475, USA. Electronic address: alpb1803@uw.edu."), [Donald L Chi](https://pubmed.ncbi.nlm.nih.gov/?term=Chi+DL&cauthor_id=42418961)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42418961/#full-view-affiliation-2 "Department of Oral Health Sciences, School of Dentistry, University of Washington, Box 357475, B509 Health Sciences Building, Seattle, WA 98195-7475, USA.") Affiliations Expand ### Affiliations * 1 Department of Oral Health Sciences, School of Dentistry, University of Washington, Box 357475, B509 Health Sciences Building, Seattle, WA 98195-7475, USA. Electronic address: alpb1803@uw.edu. * 2 Department of Oral Health Sciences, School of Dentistry, University of Washington, Box 357475, B509 Health Sciences Building, Seattle, WA 98195-7475, USA. * PMID: **42418961** * DOI: [ 10.1016/j.vaccine.2026.128900 ](https://doi.org/10.1016/j.vaccine.2026.128900) Item in Clipboard # Caregiver political affiliation is associated with childhood vaccine hesitancy but not fluoride opposition Ana Luiza Peres Baldiotti et al. Vaccine. 2026. Show details Display options Display options Format Abstract PubMed PMID Vaccine Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Vaccine%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Vaccine%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42418961/) . 2026 Aug 30:89:128900. doi: 10.1016/j.vaccine.2026.128900. Epub 2026 Jul 8. ### Authors [Ana Luiza Peres Baldiotti](https://pubmed.ncbi.nlm.nih.gov/?term=Baldiotti+ALP&cauthor_id=42418961)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42418961/#short-view-affiliation-1 "Department of Oral Health Sciences, School of Dentistry, University of Washington, Box 357475, B509 Health Sciences Building, Seattle, WA 98195-7475, USA. Electronic address: alpb1803@uw.edu."), [Donald L Chi](https://pubmed.ncbi.nlm.nih.gov/?term=Chi+DL&cauthor_id=42418961)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42418961/#short-view-affiliation-2 "Department of Oral Health Sciences, School of Dentistry, University of Washington, Box 357475, B509 Health Sciences Building, Seattle, WA 98195-7475, USA.") ### Affiliations * 1 Department of Oral Health Sciences, School of Dentistry, University of Washington, Box 357475, B509 Health Sciences Building, Seattle, WA 98195-7475, USA. Electronic address: alpb1803@uw.edu. * 2 Department of Oral Health Sciences, School of Dentistry, University of Washington, Box 357475, B509 Health Sciences Building, Seattle, WA 98195-7475, USA. * PMID: **42418961** * DOI: [ 10.1016/j.vaccine.2026.128900 ](https://doi.org/10.1016/j.vaccine.2026.128900) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Objective:** Evaluate political affiliation as a correlate of childhood vaccine hesitancy and opposition to topical fluoride and community water fluoridation (CWF). **Methods:** Data were collected from caregivers using an online REDCap questionnaire administered to 1,049 caregivers at five university- or children's hospital-based clinics in four states and via social media between November 2020 and September 2021. We assessed caregivers' political affiliation, childhood vaccine hesitancy, topical fluoride opposition, and CWF opposition. Confounder-adjusted logistic regression models evaluated associations between political affiliation and the three prevention outcomes. **Results:** A total of 833 surveys were analyzed. Participants were mostly women (79.5%) with a mean age of 41 years (SD = 8). Most caregivers had a college degree or higher (87.4%), and 36.0% reported an annual household income >$100,000. The prevalence of caregivers' childhood vaccine hesitancy was 40.9%. About 37.2% and 37.7% of caregivers were opposed to topical fluoride and CWF, respectively. In the confounder-adjusted regression model, political affiliation was significantly associated with caregiver childhood vaccine hesitancy, whereby conservative caregivers reported higher odds of childhood vaccine hesitancy than moderate and liberal caregivers (moderate: OR = 0.54, 95% CI: 0.33-0.87; liberal: OR = 0.51, 95% CI: 0.30-0.85). Caregivers' political affiliation was not significantly associated with opposition to topical fluoride or CWF (p-values>0.05). **Conclusions:** Conservative caregivers were more likely to be hesitant about childhood vaccines. Political affiliation was not significantly associated with opposition to topical fluoride or CWF. Our findings suggest that political affiliation has differential influences on various modes of childhood disease prevention. **Keywords:** Caregivers; Fluorides; Fluorides, topical; Health knowledge, attitudes, practice; Politics; Vaccination hesitancy. Copyright © 2026 Elsevier Ltd. All rights reserved. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. ## Similar articles * [ Caregivers' hesitancy and outright refusal toward children's COVID-19 vaccination in the Democratic Republic of Congo: A community-based cross-sectional study. ](https://pubmed.ncbi.nlm.nih.gov/39535129/) Guillaume AS, Ndwandwe D, Nyalundja AD, Bugeme PM, Ntaboba AB, Hatu'm VU, Tamuzi JL, Iwu-Jaja C, Shindano TA, Wiysonge CS, Katoto PDMC.Guillaume AS, et al.Hum Vaccin Immunother. 2024 Dec 31;20(1):2422686. doi: 10.1080/21645515.2024.2422686. Epub 2024 Nov 13.Hum Vaccin Immunother. 2024.PMID: 39535129Free PMC article. * [ Parents' and caregivers' role toward childhood vaccination in Albania: assessment of predictors of vaccine hesitancy. ](https://pubmed.ncbi.nlm.nih.gov/35532052/) Gjini E, Moramarco S, Carestia MC, Cenko F, Ylli A, Mehmeti I, Palombi L, Buonomo E.Gjini E, et al.Ann Ig. 2023 Jan-Feb;35(1):75-83. doi: 10.7416/ai.2022.2521. Epub 2022 May 6.Ann Ig. 2023.PMID: 35532052 * [ The Association Between Intensive Parenting Attitudes and Topical Fluoride Opposition. ](https://pubmed.ncbi.nlm.nih.gov/41556617/) Ko A, Carle AC, Tanbonliong TS, Chi DL.Ko A, et al.J Public Health Dent. 2026 Mar;86(1):60-66. doi: 10.1111/jphd.70033. Epub 2026 Jan 20.J Public Health Dent. 2026.PMID: 41556617 * [ Factors that influence caregivers' and adolescents' views and practices regarding human papillomavirus (HPV) vaccination for adolescents: a qualitative evidence synthesis. ](https://pubmed.ncbi.nlm.nih.gov/40232221/) Cooper S, Schmidt BM, Jama NA, Ryan J, Leon N, Mavundza EJ, Burnett RJ, Tanywe AC, Wiysonge CS.Cooper S, et al.Cochrane Database Syst Rev. 2025 Apr 15;4(4):CD013430. doi: 10.1002/14651858.CD013430.pub2.Cochrane Database Syst Rev. 2025.PMID: 40232221Free PMC article. * [ Media Exposure and Its Association With Vaccine Attitudes, Intentions, and Hesitancy: Systematic Review. ](https://pubmed.ncbi.nlm.nih.gov/42061834/) Leonforte F, Nicosia V, Comite P, Morlino G, Mistretta A.Leonforte F, et al.J Med Internet Res. 2026 Apr 28;28:e74280. doi: 10.2196/74280.J Med Internet Res. 2026.PMID: 42061834Free PMC article. 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Substances * Fluorides, Topical Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Fluorides%2C+Topical%22%5Bnm%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=%22Fluorides%2C+Topical%22) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42418961/) ## Related information * [ MedGen ](https://www.ncbi.nlm.nih.gov/medgen?linkname=pubmed_medgen&from_uid=42418961 "Related information in MedGen") ## LinkOut - more resources * ### Full Text Sources * [ ClinicalKey ](https://www.clinicalkey.com/content/playBy/pii?v=S0264-410X\(26\)00709-7) * [ Elsevier Science ](https://linkinghub.elsevier.com/retrieve/pii/S0264-410X\(26\)00709-7) * ### Medical * [ MedlinePlus Health Information ](https://medlineplus.gov/caregivers.html) **Full text links** [x] [![Elsevier Science full text link](https://cdn.ncbi.nlm.nih.gov/
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