Second dose of measles, mumps, and rubella vaccine: questionnaire survey of health professionals

Objective To determine the knowledge, attitudes, and practices among health professionals regarding the measles, mumps, and rubella (MMR) vaccine, par ticularly the second dose. Design Self administered postal questionnaire survey. Setting North Wales Health Authority, 1998. Participants 148 health visitors, 239 practice nurses, and 206 general prac titioners. Main outcome measures Respondents' views on MMR vaccination, including thei r views on the likelihood of an association with autism and Crohn's disease and on who is the best person to give advice to parents, whether they agre e with the policy of a second dose of the vaccine, and how confident they a re in explaining the rationale behind the second dose. Results Concerning the second dose of the vaccine, 48% of the professionals (220/460) had reservations and 3% (15) disagreed with the policy of giving it Over half the professionals nominated health visitors as the best initi al source of advice on the second vaccine. 61% of health visitors (86/140), compared with 46% of general practitioners (73/158), reported feeling very confident about explaining the rationale of a two dose schedule to a well informed parent, but only 20% (28/138) would unequivocally recommend the se cond dose to a wavering parent 33% of the practice nurses (54/163) stated t hat the MMR vaccine was very likely or possibly associated with Crohn's dis ease and 27% (44/164) that it was associated with autism. Nearly a fifth of general practitioners (27/158) reported that they had not read the MMR sec tion in the "green book," and 29% (44/152) reported that they had not recei ved the Health Education Authority's factsheet on MMR immunisation. Conclusions Knowledge and practice among health professionals regarding the second dose of the MMR vaccine vary widely. Many professionals are not awa re of or do not use the good written resources that exist, though local edu cational initiatives could remedy this.