ObjectiveTo investigate factors associated with parental intention of refusing or altering their child's vaccination schedule.MethodsData were from the 2011–2012 Listening to Mothers III survey (N = 1,053). Weighted bivariate and multivariate analyses examined factors related to refusing or altering vaccination.Results3.2% of mothers planned to refuse vaccination and 12.3% preferred to alter the recommended schedule. Preference to refuse was associated with maternal age <25 years (AOR 4.33; 95% CI: 1.18, 15.9), prior refusal of maternity care (AOR 6.04; 95% CI: 1.88, 19.4), and living outside of the Northeast. Schedule modification was only associated with prior refusal of care.ConclusionsMothers preferring not to immunize their children and those wishing to alter the vaccination schedule represent two distinct groups.