Managing controversy through consultation: a qualitative study of communication and trust around MMR vaccination decisions
- PMID: 15239914
- PMCID: PMC1324804
Managing controversy through consultation: a qualitative study of communication and trust around MMR vaccination decisions
Abstract
Background: Controversy over the measles, mumps, and rubella (MMR) vaccine has reduced uptake, raising concerns of a future disease epidemic.
Aims: To explore parents' accounts of decision making relating to the MMR vaccine controversy, identifying uptake determinants and education needs.
Design of study: Qualitative interviews analysed using the 'framework' approach.
Setting: Five general practices in the Leeds area, 2002-2003.
Method: Sixty-nine interviews conducted with parents of children aged between 4 and 5 years, and 12 interviews with primary care practitioners, managers and immunisation coordinators serving participating sites. Participants were interviewed one-to-one in a place of their choice.
Results: The vaccination decision is primarily a function of parental assessments of the relative acceptability and likelihood of possible outcomes. For most parents the evidence of science and medicine plays little role in the decision. Although local general practitioners and health visitors are trusted information sources, the influence of primary care providers on the vaccination decision is limited by concerns over consultation legitimacy, discussion opportunity, and perceptions of financial and political partiality. Parents and practitioners identify a need for new approaches to support decisions and learning when faced with this and similar healthcare controversies. These include new collaborative approaches to information exchange designed to transform rather than supplant existing parent knowledge as part of an ongoing learning process.
Conclusion: The study identified new ways in which parents and practitioners need to be supported in order to increase understanding of medical science and secure more informed decisions in the face of health controversy.
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Comment in
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Engaging with the public?Br J Gen Pract. 2004 Jul;54(504):493-4. Br J Gen Pract. 2004. PMID: 15239909 Free PMC article. No abstract available.
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Parents' decisions on MMR vaccination for their children were based on personal experience rather than scientific evidence.Evid Based Nurs. 2005 Apr;8(2):60. doi: 10.1136/ebn.8.2.60. Evid Based Nurs. 2005. PMID: 15830433 No abstract available.
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- Department of Health. Combined measles, mumps and rubella vaccine: response of the Medicines Control Agency and Department of Health to issues raised in papers published in ‘Adverse Drug Reaction and Toxicology Reviews. London: Department of Health; 2001. Volume 19 no.4. 2000. http://medicines.mhra.gov.uk/ourwork/monitorsafequalmed/safetymessages/m... (accessed 10 Jun 2004)
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- Department of Health. Statement on the safety of the MMR vaccine programme. London: Department of Health; 2001.
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