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This study examines the relationship between use by health professionals of the standard Child Health Computer System in its role of scheduling and monitoring immunisation, and the apparent uptake rate of measles immunisation. Records held by the computer, health authority clinic and general practitioner on a sample of children born in 1981 in Maidstone Health Authority were searched separately to identify anomalies and their possible effects on the uptake rate, estimated by the computer system as 74 per cent Nine reasons for non-uptake among those recorded on the computer file as unimmunised were studied. Previous measles disease applied to 35 per cent of unimmunised children, non-recording for children who were in fact immunised applied to 15 per cent, non-uptake of earlier immunisations to 24 per cent, withdrawal of consent for measles immunisation to 37 per cent, and unrecorded change of address to 15 per cent The computer system should have continued to schedule immunisation appointments despite non-uptake of earlier immunisations and despite reports of measles disease. Notification by health professionals of uptake of immunisations and of measles disease needs to be greatly improved. Notification of changes of address, especially where this involves movements in or out of thedistrict, are essential to identify the eligible population correctly We believe that given these improvements in the transfer of information between health professionals, parents and the computer system, an uptake rate of 90 per cent is feasible.
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