REASONS FOR NON-UPTAKE OF MEASLES, MUMPS, AND RUBELLA CATCH-UP IMMUNIZATION IN A MEASLES EPIDEMIC AND SIDE-EFFECTS OF THE VACCINE

Objectives-To investigate the reasons for poor uptake of immunisation (non-immunisation) and the possible side effects of measles, mumps, an d rubella vaccine in a catch up immunisation campaign during a communi ty outbreak of measles. Design-Descriptive study of reasons for non-im munisation and retrospective cohort study of side effects of the vacci ne. Setting-Secondary schools in South Glamorgan. Subjects-Random clus ter sample of the parents of 500 children targeted but not immunised a nd a randomised sample of 2866 of the children targeted. Main outcome measures-Reasons for non-immunisation; symptoms among immunised and no n-immunised children. Results-Immunisation coverage of the campaign wa s only 43.4% (7633/17 595). The practical problems experienced include d non-return of consent forms (6698/17 595), refusal of immunisation ( 2061/10 897 forms returned), and absence from school on day of immunis ation (1203/8836 children with consent for immunisation). The most com mon reasons cited for non-immunisation were previous measles infection (145/232), previous immunisation against measles (78/232), and concer n about side effects (55/232). Symptoms were equally common among immu nised and non-immunised subjects. However, significantly more immunise d boys than non-immunised boys reported fever (relative risk 2.31 (95% confidence interval 1.36 to 3.93)), rash (2.00 (1.10 to 3.64), joint symptoms (1.58; 1.05 to 2.38), and headache (1.31 (1.04 to 1.65)). Con clusions-Many of the objections raised by parents could be overcome by emphasising that primary immunisation does not necessarily confer imm unity and that diagnosis of measles is unreliable. Measles, mumps, and rubella vaccine is safe in children aged 11-15.