Parental perceptions of childhood immunisation in the context of the MMR controversy
This qualitative study examines how parents have conceptualised the MMR controversy and offers an assessment of parents’ perceptions of vaccine-preventable diseases and childhood immunisation. Methods-Eighteen focus groups were conducted in central Scotland between November 2002 and March 2003, with a diverse range of parents to ensure maximum variation in terms of age, socio-economic circumstances, likely views about vaccination and family circumstances. Findings-There are some potentially serious misunderstandings and gaps in knowledge about many of the diseases, which generally led to a diminished sense of urgency for vaccination. Parents deciding about MMR vaccination have to balance the perceived risk of disease against the perceived risk of MMR, and the perceived ability of their child’s immune systems to cope with the challenge of vaccines, or to fight the disease. Parents often questioned the safety of combining several antigens into one vaccine, as they were concerned it could be too potent for their child’s immune system and could potentially cause long-term damage. In some circumstances parents preferred to withhold MMR vaccination because it was easier for them to live with the risk of their child naturally contracting one of the diseases than with the risk of causing their child permanent damage as they perceived other parents may have unwittingly done. There is also a need for further research to investigate how parents caring for autistic children have been affected by the debate and to reassure parents based on sound evidence that giving these vaccines in a combined form is safe. Indeed, as the new pentavalent vaccine (DtaP/IPV/Hib) is introduced into the programme, it is crucial that these concerns about immune overload are taken into account to reassure parents in their wider reappraisal of vaccine risk.