Giving parents confidence about childhood vaccinations
Local authorities aim to have a minimum of 90 per cent of children immunised in order to protect both the individual child and the overall population (www.gov.uk/phe www.chimat.org.uk). Hammersmith and Fulham, Westminster and Kensington & Chelsea currently perform poorly, with Westminster having the lowest uptake in the UK of both the MMR and Dtap/IPV/Hib vaccines, achieving only 73.8 per cent. The reasons for parents not vaccinating their children are poorly understood (Simpson N, Lenton S, Randall R. Parental refusal to have children immunised: extent and reasons. BMJ 1999; 310: 227).
According to a questionnaire completed by 50 mothers, we found that only 52 per cent of respondents thought that vaccination is a good way to protect their child, and only 48 per cent accepted that the MMR vaccine is not linked with autism. While responses indicated that the health visitor was the most common source of information, they also suggested that the health visitor approach could be off-putting.
If we want to alter the vaccination uptake rate, we must listen to and address parental concerns relating to vaccinations. Furthermore, in areas where ethnic minorities make up the majority of the local population, cultural differences must be acknowledged and the method of information-giving modified — for instance, information should be available in a language that a parent can understand, and a well-informed professional should be on hand to address any worries. Using people from the local community to help spread the word about vaccinations may be a useful way to reach members of the community who don’t respond to conventional methods of information giving.
The source and the timing of information regarding vaccinations is important; many parents expressed the wish to have more information from their GP face-to-face. Information about vaccinations that is offered in the first few weeks of a child’s life can often be overwhelming; the message that ‘vaccinations are good’ is likely to go unheard among the stresses of these early weeks.
Spending time with parents and exploring their ideas, concerns and expectations surrounding childhood vaccinations has been an invaluable experience. I hope that we can use this insight to help healthcare professionals recognise when and how information surrounding vaccinations can be delivered, with the ultimate aim of making parents feel empowered and confident in their decision to vaccinate their children.