The psychological barriers facing MMR promotion campaigns

A focus group study of parents' attitudes towards interventions promoting uptake of the MMR vaccine suggests it is better for health advice to be seen as independent from government.

The findings come after the General Medical Council ruled yesterday that Andrew Wakefield, the doctor who first suggested a link between the MMR vaccine and autism, was guilty of serious professional misconduct.

The MMR vaccine protects children against measles, mumps and rubella. Unfortunately the number of UK parents vaccinating their children plummeted in the wake of Wakefield's 1998 Lancet study, since discredited and un-replicated, which purported to show a link between the MMR vaccine and autism. Today vaccination rates remain at around 85 per cent, compared with the desired rate of 90 to 95 per cent required for herd immunity (whereby even the unvaccinated are safe).

For the new study, Benjamin Gardner and colleagues analysed five focus group interviews they held with 28 parents in London. The parents were asked for their responses to three 'motivation-based' interventions (a website; an information pack; and parent-led group discussions) and three 'organisational interventions' (health care workers acting as immunisation champions; mobile vaccination units; legislation to penalise non-compliers).

Five key themes emerged. Parents felt they didn't have enough information, especially in relation to the dangers associated with not vaccinating. Government sources were not trusted. By contrast, other parents were trusted: 'Parents trust advice from other parents,' one mother said. '[You] take it on board. You listen to them.' Parents also revealed they were biased towards risk-related information. And they misunderstood balance, believing that pro- and anti-MMR arguments should be given equal weight even though the scientific evidence overwhelming favours MMR vaccination.

Gardner's team said a number of practical implications emerged from their findings. In particular, promotional MMR campaigns are likely to be better received if they appear to be independent of government and if they are fronted by parents. More information is needed about the risks of non-vaccination. And care should be taken when highlighting the small risks associated with vaccination - parents are likely to zoom in on these.

The researchers acknowledged their study has some limitations, most notably that the majority of the parents involved had actually vaccinated their children. Nonetheless, they said their results 'highlight important psychological barriers and facilitators that may determine whether MMR promotion interventions are effective.'
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Gardner B, Davies A, McAteer J, & Michie S (2010). Beliefs underlying UK parents' views towards MMR promotion interventions: a qualitative study. Psychology, health & medicine, 15 (2), 220-30 PMID: 20391239

Also on the Digest: How to promote the MMR vaccine.