ANCHORAGE, Alaska — A survey of mothers of young Alaska children confirms that fewer kids are receiving vaccinations that could combat preventable diseases.

The number of mothers who delayed or refused shots for their children increased from 23.8 percent to 33.2 percent between 2009 and 2011.

“Our immunization rates are going down,” Margaret Young, a state public health specialist, told the Anchorage Daily News. “The state is trying to find out why.”

Across the nation, Young said, critics question the need for vaccines and whether they are safe or effective. The American Academy of Pediatrics and other health organizations say vaccines have been studied thoroughly and protect infants and children from diseases that can kill.

A 2011 National Immunization survey indicated Alaska ranked 39th immunization among toddlers.

The Alaska survey quizzed random mothers of 3-year-old Alaska children and asked whether they had delayed or decided against vaccine shots or immunizations.

Nearly 54 percent said too many shots were given at once, 44 percent said shots were given too early and 28 percent expressed concern that the shots’ disadvantages outweighed the benefits.

Some who declined shots cited religious beliefs.

Others said they were not aware of the timing of vaccinations or that they worried about bad reactions to shots.

Mothers who said their doctor knew their child well were more likely to vaccinate.

Dr. Monique Karaganis, an Anchorage pediatrician, said she believes vaccinations are safe and that 95 percent of her patients receive the shots.

But not all of her patients’ parents believe the vaccines are safe.

“(To be my patient) you don’t have to vaccinate your child but you have to be willing to read my information,” she said. “You have to be willing to talk to me about vaccines.”

Parents who said they delayed or declined shots for their children were labeled “vaccine hesitant” in the state survey. White, college-educated mothers over the age of 35 were most likely to report that they had delayed or skipped immunization.

The highest rates of vaccine hesitancy, 42.8 percent, were found in the Kenai Peninsula, Kodiak and Prince William Sound region. The rate in interior Alaska was 31.6 percent.

In the Anchorage and Mat-Su region, 26.3 percent of respondents reported vaccine hesitancy.

Northern Alaska mothers reported the lowest rate of vaccine hesitancy, 17.3 percent.

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Information from: Anchorage (Alaska) Daily News, http://www.adn.com