In the United Kingdom, childhood immunisation has become a controversial issue, which is an ongoing challenge for health professionals. When claims were made by Wakefield et al, of a link between MMR, inflammatory bowel disease and autism, and parents’ concerns were being fuelled by sensational reporting in the media, the Department of Health took the approach to firmly deny that immunisations were attached to such risks. Some parents were not convinced and some lost trust in the information given by health professionals about immunisations.
However, health professionals do now have a huge body of good research evidence available to them, which indicates the effectiveness and safety of the vaccines.
Here, the parents we interviewed talk about what helped and what didn’t help them when discussing their child’s immunisations with a health professional.
The overwhelming majority of parents believe in immunisation for their children. We have however included here the views of a few parents who do not believe immunisation is right for their own child based on their personal beliefs. Their views represent a small proportion of the population.
Building trust with parents
- When health professionals acknowledged and explained all the risks involved with immunisations, parents felt more able to trust them, than when concerns about potential risks were dismissed.
- When parents felt that doctors were giving their own professional opinion based on an assessment of the child’s personal medical history, rather than just giving out a government line, they were more likely to trust what health professionals were saying.
- When health professionals didn’t just assume that their child would be immunised but talked about the choices parents had, parents were more likely to take on board the advice that was being given.
- Parents would like health professionals to be open and honest about the reasons behind some of the advice they give.
- Parents want to feel partners in informed decision-making and not to feel coerced in to immunising their children.
- Parents would like the vaccine product insert sheets detailing the components of the vaccine, when the manufacturer states it shouldn’t be given and the side effects associated with their products. Information on adverse vaccine events is not collected reliably through the ‘yellow card’ scheme and adverse vaccine events are under reported.
Respect parents’ worries and listen to their concerns
- Take time to answer questions or discuss concerns and help parents to be well informed. Provide copies of the vaccine manufacturers’ product insert sheets and discuss the contraindications in relation to the child’s personal and family medical history. Respect parents’ concerns and be open to their suggestions, volunteer information and invite parents to ask questions.
- Don’t treat parents as if they are stupid.
- Don’t treat the MMR decision in a flippant way. Payments have been awarded by the Government’s Vaccine Damage Payment Unit for children who have been affected by vaccines.
- Don’t assume that at the six-week check, parents will be having the immunisations. This may be the first time the subject of immunisation has been raised. Some parents will need time to consider the issues in relation to their child’s health and medical history. They will need comprehensive information and all parents should have access to a trained health professional to talk to about the risks of catching the diseases and about the benefits and potential risks of immunisation for their own child, and the population in general.
- Listening to parents and being able to answer their concerns with comprehensive information can influence the decisions parents make about their child’s immunisations.
- When parents bring their child to see a health professional with concerns that their child may have had a reaction to MMR, be sympathetic, note the symptoms, study the vaccine manufacturers’ product sheets or the Green Book and report the suspected adverse event for investigation, if appropriate.
Give reassurance and try to understand what it’s like from a parent’s perspective
- Health professionals should be prepared to answer questions from parents about the immunisation decisions they made for their own children but should ensure that they have also balanced the risks for the individual child in front of them.
Be well informed so that you can give parents the information they need
- Well informed health professionals, who discussed issues with confidence and were able to provide reassurance helped to instil trust in parents.
- Some parents found it more helpful to talk to a trained health professional than being given written information. But not all parents want information and the opportunity to discuss immunisations with a health professional.
The immunisation clinic
- A child friendly clinic, held at convenient times, with friendly, well informed trained health professionals can make a difference to parents’ decisions to return for future immunisations.