Parents' perspectives on the MMR immunisation: a focus group study

Background: The uptake of the combined measles, mumps and rubella immunisat ion (MMR) in Britain has fallen since 1998, when a link was hypothesised wi th the development of bowel disorders and childhood autism. Despite reassur ances about the safely of MMR, uptake levels remain lower than optimal. we need to understand what influences parents' decisions on whether to accept MMR or not so that health professionals can provide a service responsive to their needs. Aim: To investigate what influences parents' decisions on whether to accept or refuse the primary MMR immunisation and the impact of the recent contro versy over its safety. Design: Qualitative study using focus group discussions. Setting. Forty-eight parents, whose youngest child was between 14 months an d three years old, attended groups at community halls in six localities in Avon and Gloucestershire. Methods Purposive sampling strategy was used to include parents from a vari ety of socioeconomic backgrounds. Three groups comprised parents who had ac cepted MMR and three groups comprised parents who had refused MMR. Data ana lysis used modified grounded theory techniques incorporating the constant c omparative method. Results. All parents felt that the decision about MMR was difficult and str essful, and experienced unwelcome pressure from health professionals to com ply, Parents were not convinced by Department of Health reassurances that M MR was the safest and best option for their children and many had accepted MMR unwillingly. Four key factors influenced parents' decisions: (a) belief s about the risks and benefits of MMR compared with contracting the disease s, (b) information from the media and other sources about the safely of MMR , (c) confidence and trust in the advice of health professionals and attitu des towards compliance with this advice, and (d) views on the importance of individual choice within Government policy on immunisation. Conclusions. Parents wanted up-to-date information about the risks and bene fits of MMR to be available in advance of their immunisation appointment. M any parents did not have confidence in the recommendations of health profes sionals because they were aware that GPs needed to reach immunisation targe ts. Most parents would, however, welcome more open discussion about immunis ation with health professionals.