The two-dose measles, mumps, and rubella (MMR) immunisation schedule: factors affecting maternal intention to vaccinate.

Manish Pareek · Helen M. Pattison

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Vaccine Coverage and Hesitancy Virology and Viral Diseases Intramuscular injections and effects

Abstract

BACKGROUND: In the light of sub-optimal uptake of the measles, mumps, and rubella (MMR) vaccination, we investigated the factors that influence the intentions of mothers to vaccinate. METHOD: A cross-sectional survey of 300 mothers in Birmingham with children approaching a routine MMR vaccination was conducted using a postal questionnaire to measure: intention to vaccinate, psychological variables, knowledge of the vaccine, and socioeconomic status. The vaccination status of the children was obtained from South Birmingham Child Health Surveillance Unit. RESULTS: The response rate was 59%. Fewer mothers approaching the second MMR vaccination (Group 2) intended to take their children for this vaccination than Group 1 (mothers approaching the first MMR vaccination) (Mann-Whitney U = 2180, P < 0.0001). Group 2 expressed more negative beliefs about the outcome of having the MMR vaccine ('vaccine outcome beliefs') (Mann-Whitney U = 2155, P < 0.0001), were more likely to believe it was 'unsafe' (chi 2 = 9.114, P = 0.004) and that it rarely protected (chi 2 = 6.882, P = 0.014) than Group 1. The commonest side-effect cited was general malaise, but 29.8% cited autism. The most trusted source of information was the general practitioner but the most common source of information on side-effects was television (34.6%). Multiple linear regression revealed that, in Group 1, only 'vaccine outcome beliefs' significantly predicted intention (77.1% of the variance). In Group 2 'vaccine outcome beliefs', attitude to the MMR vaccine, and prior MMR status all predicted intention (93% of the variance). CONCLUSION: A major reason for the low uptake of the MMR vaccination is that it is not perceived to be important for children's health, particularly the second dose. Health education from GPs is likely to have a considerable impact.

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References

1986Prediction of goal-directed behavior: Attitudes, intentions, and perceived behavioral control 1999Autism and measles, mumps, and rubella vaccine: no epidemiological evidence for a causal association

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2017Critical Elitism: Deliberation, Democracy, and the Problem of Expertise 2016Determinants of European parents' decision on the vaccination of their children against measles, mumps and rubella: A systematic review and meta-analysis 2011Anatomy of a health scare: Education, income and the MMR controversy in the UK 2012Healthcare workers’ role in keeping MMR vaccination uptake high in Europe: a review of evidence 2018Using protection motivation theory to predict intention to adhere to official MMR vaccination recommendations in Switzerland 1999Negative association between MMR and autism 2008A content analysis of mass media sources in relation to the MMR vaccine scare 2020Patterns in Wealth-related Inequalities in 86 Low- and Middle-Income Countries: Global Evidence on the Emergence of Vaccine Hesitancy

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