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Immunisation

Information from health professionals

Every parent should have access to a trained health professional to chat 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. In addition to their GP, health visitor or practice nurse, there is also an immunisation advisor in each local health protection unit, whom parents can talk to about their child's immunisations. (See Public Health England for details about local contacts). The GP can also refer parents to an immunology paediatric specialist for further advice on immunisations, if appropriate. 

Many parents we interviewed felt strongly that doctors, health visitors and midwives would not give advice to parents if they believed it wasn't true or safe. Some felt that, when making decisions, it is best to be led by the health professionals because they are the experts. 

 

Explains why she trusted the information given by the health visitor and practice nurse.

Explains why she trusted the information given by the health visitor and practice nurse.

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I guess people just have to feel happy that they're, they've got the information they need. I would say I'd worry about people not trusting healthcare professionals. I would say you know, I feel quite strongly that people can trust their GPs or health visitors, practice nurses, and use those as, use them as a source of information. I don't think finding information on the Internet necessarily, about healthcare necessarily is that, is very helpful, and it's really not necessarily regulated, or you can't count on it being truthful. I think there is a, perhaps a tendency for people not to trust healthcare professionals as much as they used to, which in some ways, you know, that's people have got to, have got to be quite questioning. But I do feel on issues such as this, GPs, practice nurses and health visitors they're really not going to wish any harm on people or, or children. And I think for if one moment they thought that there was great danger that they would say so. I don't think they're, sort of just doing it because they've been told to. So, so I'd say ask them and trust them.

Having worked in healthcare for some time, I just, it's just noting most GPs' or nurses' natures to, that's not why people go into the profession really. It's, I don't think that's necessarily true. And I think, you know, people like for example health visitors don't, certainly don't get paid. And I think they'd be one of the first people to notice if there was a link and, and say so I think if they would feel it was their responsibility to do so. And so I think they, in my opinion they can certainly be trusted.

 

Believes that when you want expert advice you should talk to the professionals who have spent...

Believes that when you want expert advice you should talk to the professionals who have spent...

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So I think it is very, very, very important here and everywhere else to educate people, to inform them. Not misinform them, which is what the media usually does. If you buy a tabloid, they just care about selling papers, and the best way to sell them is to shout horrible stories, you know, and, and pick the one in a million case where something went wrong, instead of stressing that the other 999,999 actually didn't have any problems and were protected, yes. The media are always using sensation to sell. But on the other hand you are the parent, you have your child to look after and you want the best for your child. You shouldn't listen to sources of information which are not the right ones. And I think if, if we don't know much about something, we should go and ask the right people. There's always your GP, your health care or a nurse that can give you the information you require, can actually, not just tell it to you but give you access to documentation, where you can make your mind up by yourself without just listening to it on TV or on tabloids. So I think it's very important to educate people the right way, to give them the proper information.

In the past decade, however, some parents in the UK have doubted the information they received from health professionals about their child's immunisations. 

“I talked to my GP who I've always trusted implicitly and she said that the MMR was safe as far as she knew and that was the first time that I thought, but you work for the NHS I bet that's not true what you told me. Which now a year after he had the MMR it's quite bizarre to think I could have thought that about my GP.”  [Interview 31- Mother of a 2 and half-year-old boy.]

Sensational reporting in the media, conspiracy theories, and lack of trust in the government, has done much to place doubts in the minds of some parents about the information given by health professionals about immunisations in the belief that they were following a government agenda, which might not be appropriate for their child. 

However, health professionals do now have a huge body of research evidence available to them, all of which indicates the effectiveness and safety of the vaccines.

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.

Parents had talked to their health visitor, the practice nurse, their GP, their midwife, and in some cases to an immunology specialist or to a homeopathic practitioner. Some got a second opinion from a private GP or medically trained friends and relations. 

 

Talking about their concerns to a health professional can sometimes help parents to make their...

Talking about their concerns to a health professional can sometimes help parents to make their...

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So, the other concern is, is at the moment I've found a lot of parents are quite wary about giving the six-in-one or the five-in-one and then the meningitis C with it. And I felt often it just takes quite a lot of reassurance. Some of them don't necessarily seem to be aware that we actually are giving the same vaccines that they were before. It's just in a different form. And it's 'oh isn't that a lot to be giving at the same time?' It's like well we have been doing that for years and just explaining that. Often it just needs a few minutes of time and, and just addressing their concerns and making sure they've got the correct information which often they don't. And sometimes that's all it needs, not always but often if they do have a chat with myself or the health visitor or with the immunisations nurse you know often it will correct their misconceptions and there are quite a lot out there unfortunately. I've found that. There are a lot of people who just, particularly from the media, have, have just picked up what they want to hear and ignored the rest and that's then [pause] made them choose what may not necessarily be the right thing.
 
 

Information given to her by a midwife at a birth group influenced her decisions for her children...

Information given to her by a midwife at a birth group influenced her decisions for her children...

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Well it was when my eldest daughter was born which was twelve years ago now and I contacted a birth group for support with a home delivery. And after she was born the lady, the midwife who ran the birth group asked me if I'd considered vaccinations and at that point I hadn't really thought about it. I was just going to go along with the flow really and have her vaccinated. And she gave me some information to read. And it really all followed from that. 

I read that which sort of sewed a seed of doubt in my mind. It was books written by various doctors and articles interviewing parents whose children had been damaged from being what they believed from, from the vaccines. And I just really started to seek out as much information as I could.

Most parents found that talking to health professionals had been the best source of information to reassure them when they had concerns about immunisations. Parents' perceptions of the information given by health professionals were sometimes affected by how well they knew their GP.

 

Information given to her from a health professional was very important in helping her to decide...

Information given to her from a health professional was very important in helping her to decide...

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And then our little boy was born and I had the same reservations but again went straight back to this lady at Great Ormond Street. She reiterated everything she'd said before and also I was interested in finding out if there was any more data, has anything happened because there's 3 ' years difference between the two. And she was just able to tell me exactly what the, the current sort of comment was on it and stuff and, and also it wasn't just her giving me the facts, she was also talking to me as a mother as well. She's got children of her own and she was talking to me from that perspective. So I kind of felt, unlike with our local doctor who I, you know, other people were commenting, 'Oh they will just give you the party line,' I felt as if she was telling me exactly what all the facts were as well as the fact she was a mother and she was also being honest with me about how she felt about it.

But I think I really needed to hear the way that this lady spoke, it was very much a case of, you know, her comments seemed to be along the lines of that, you could give one child a ham sandwich and they'll be perfectly fine, you can another child a ham sandwich and they might have reaction to that. So there's always going to be this possibility that a small percentage of children might have a reaction, but like they might do to anything you might cook for them or something. But, that over-ridingly it's safe.

And she was, you know, very sort of from a sort of top overview telling me about the information that's coming from the States and various other countries and how many countries are actually using the MMR and how many years they've been using the MMR and that, you know, there is not a link, that, you know, and I think I needed to hear someone in her position saying, 'There is not a link between the MMR and autism.' And, so I think that's, like I say, and I think it was having that initial conversation where she said that, that really kind of tipped me over to think, 'Yeah, OK, I think we're going to go with doing this.'

 

After much anxiety, the information their GP told them helped them to make up their minds about MMR.

After much anxiety, the information their GP told them helped them to make up their minds about MMR.

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Well, I talked to my own doctor, at length, and the health visitor. They of course were both, you know, sort of people you look up to and health professionals. And they couldn't stress enough how I wasn't to worry and how I should give [my daughter] the MMR because the downside was a lot worse. And if she didn't have the MMR, you know, the things that could happen to her, how dangerous measles can be, and like the German measles could affect her when she's older and goes to have children of her own, you know, the rubella side of it. And these health professionals, I'm trying not to say the names, they were sort of, they've got no reason to say otherwise. If they for one minute thought that there would be a problem with MMR it's more than their careers are worth to push me to give it to my little girl. 

And in the end that's where I thought, 'Well' because my doctor who is a family friend and, as well, I just knew he wouldn't, he would not have staked his career on it. And, you know, I mean he just said, 'Come on, give her here, I'm going to do it now'. And he did it. And it was, and it was talking to them really and realising that they wouldn't say those things if they didn't truly believe them, you know.

 

A paediatric immunologist was able to provide her with enough information to make what she feels...

A paediatric immunologist was able to provide her with enough information to make what she feels...

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So I went back to my GP and he was extremely helpful. And he did give me the number of a paediatric immunologist. And the person I spoke to, called me back very quickly and he was, basically, he was able to provide me with enough information, to make what I feel was the right decision. Firstly, because I'd found out the facts and I can't remember who told me this, but the five-in-one injection, has only been around for a few months. But apparently, a very similar form have been used in Canada, for about seven years, so it wasn't as if this was a new vaccination and no one really knew what was going, you know, what reaction it could have. It had been tried and tested somewhere else for some time, although it wasn't identical. 

The other thing was the fact that which was key, was the fact that if you only have two out of the three sets, you really can't, it's not as if you can say, well that almost covers you, the third is just a safety check. You know, you cannot say that you've got sufficient cover after having two. So they always recommend that you have all three, if you possibly can. So that was really helpful. And a third thing was, that he reiterated the fact that any severe reaction would happen very quickly. So I would actually be in hospital at that time.

I had a five-minute, less than ten-minute call, with this paediatric immunologist, and it just was like a breath of fresh air. It was a huge relief because I felt I could then, make a, the best decision that I could make, under the circumstances, being always aware that there was a risk and it actually went extremely well. So and I'm very pleased that I went ahead and actually I'm, I'm pleased that I made the decision. And I'm pleased that it went well at the hospital and that's she's now protected against those illnesses.

 

The advice and information she got from a paediatrician helped her to decide to give her...

The advice and information she got from a paediatrician helped her to decide to give her...

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He was someone, I, with [my son] being premature I saw a consultant, when he first came out of hospital, every two months, then every four months, then every six months. So a doctor that had worked with [my son] in hospital, so someone that knew me and knew [my son]. And I knew he had kids. And he didn't think twice in saying, 'Get it done'.

Did you ask him if he'd done that with his own children?

Yes, yes.

Did that make a difference?

It made a difference to me. I just talked to not lots of doctors, but I just thought, 'He's a really smart guy' you know. I mean he's a consultant for premature babies, he's so smart. I just don't believe in my heart that doctors would give you that information if for one minute they thought it would cause a problem. And I do believe that. I mean he's a very smart guy. And I think if he believed that maybe there are problems he would just say, 'It's your choice. I can't say'. But he did actually really promote it and said, 'It's really important that he gets it'. I mean it was still ultimately my choice, but I felt like he, you know, he's a smart guy, he works in the field, he works with babies all the time and I'm sure he sees the problems of not immunising children.

 

If she had been able to talk to the doctor who had been her GP for most of her life, she would...

If she had been able to talk to the doctor who had been her GP for most of her life, she would...

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What were the doctor, your doctor at the time or the health visitors, what were they saying?

I found them quite matter of fact. It was almost as though it was a topic that wasn't necessarily up for discussion. They were far more ready to outline the positives of having the vaccination than not having. To me, the health visitor's issue was either immunisation or not, not how to immunise. That didn't seem to come into the equation.

And for you it was the how to was the important thing?

It was, yes, absolutely. But then that made me think, well perhaps, you know, there are, they're taking this line because they are convinced that there is no real link with autism and therefore it's not a consideration for them. So it's just an awful lot to take on, take in, and an awful lot going on and it's hard to know, you know, when you're not medically minded, how to reach the decision.

I suppose so because, thinking about it, if I had been able to go to the GP that I'd had prior to leaving the UK, who had delivered me and so I had known all my life, I think if I'd have had a chat with him, it sounds silly to say whatever his opinion would have been I would have shared, but I would certainly have respected, yeah, most definitely. Because I would feel that he's, you know, he's the expert, he's better placed than I am to come to a decision.

Some parents said they would have liked more information on immunisations from health professionals, for example, getting answers to the questions they had, getting further information on facts they had read about, or talking about their particular concerns (see 'What type of information do parents want?').

 

When they weren't getting the information they needed from the health professionals about...

When they weren't getting the information they needed from the health professionals about...

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We have a very supportive surgery. The nurse there was very happy to talk to us. I think there is, I suspect the GPs feel that there isn't any case to answer and that MMR is safe and for many children it probably is. But they were open-minded, they were happy to talk to us, and we have had absolutely no pressure at all from them to vaccinate any further. They understood our concerns, they understood our reasoning for the decisions we took, and have, if not, I wouldn't go so far to say that they've been supportive, but have been understanding.

But many times we had done far more research. And at the end of the day a GP is a general practitioner, they can't be expected to be experts in every field. But what frustrates me is when you get to see somebody who is sometimes an expert in a particular field and they are still very reluctant to acknowledge bowel damage, that lactose intolerance truly exists and that both children had had it from birth, which we are led to believe is very unusual.

So there was a, you know, we felt quite rebutted a number of times. But in many ways it, it worked well for us because it gave us a natural scepticism about I guess the medical profession. And so that's what drove us to then do our own research and do the amount of research we did. Whereas, you know, maybe if people had just said, 'Oh, yes, you're right' or, 'you need to do this' we wouldn't have actually been driven. But because we were being, I guess people just didn't know that much or, you know, if they did, they didn't have the depth of information that we actually felt we had to do ourselves. It was up to us to make that choice for our children, it was up to us to do that research. So that's the path we led.

 

She had difficulty getting information from her GP because her GP didn't have access to...

She had difficulty getting information from her GP because her GP didn't have access to...

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I think it was actually quite disappointing because, I mean everybody here told me, 'Oh, don't even talk to your GP. They won't even help you' and so on and so on. But I thought, 'No, I actually want to give it a try'. And I made an appointment with her and I think she's actually a quite good GP. And I thought, 'I just want to know what she says,' after I had read the book and I actually had made a decision, 'Okay, I'm going to go for the measles single jab for now'. And I went to talk to her and I actually asked her also if I can have access to the single measles jab and she said, 'No, absolutely, we don't, we can't do it.' I asked her, 'Can you order it, can I order it and you inject it?' She said, 'No, we can't do that, we're not allowed I think' she said. 'And I know there are clinics' she said, 'where you can go, but I don't know any of them.' And I asked, 'Well, don't, can't you help me at all because obviously if I go and find a clinic online how do I know that they are trustworthy?' So, but I couldn't get anything out of her.

I would liked, I mean the whole situation, not only with the GP but also with the health visitor, the whole medical team in a way to be a little bit more open-minded and a little bit more helpful, a little bit more listening, a little bit more open for, for alternatives in a way. I mean I know the system here works differently and obviously a GP never is a homeopath, a GP never has had any training in alternative medicine. So I do appreciate it's different here. But I still think that they should be more open-minded to the, especially to the, to the worries of parents, because it's not, it's not easy to make the decision. And they just want to assure you with their facts.

But if you read a lot about vaccinations, which almost every parent does, I think it, what happens is that the parent knows more than the GP often. I mean I know I don't know more than her, but in that conversation I had with her I actually thought I had gathered more information than she had, which is not very reassuring. And you, I felt left alone.

I have to actually say in fairness that the GP did call me back and she gave me the same clinic that I had got from JABS. So she was actually sincere when she said she hasn't got any access. I think they really don't do that, they don't have any access, and she was trying to do her best to get me a clinic, get me the name of the clinic.

 

When the health professionals she talked to weren't willing to discuss her concerns it made her...

When the health professionals she talked to weren't willing to discuss her concerns it made her...

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And I think also, I found, what I found particularly disturbing was that when I did try to discuss it with any health professional they were very dismissive and just wanted really not to be having the conversation. And I found that, that seemed to answer a question in itself that, 'What were they covering up? You know, if there's, if there's nothing wrong, why won't they discuss it openly, you know, with me?' So, you know, I found that, you know, gave me more answers than actually discussion, discussing it.

 

Thought the information her GP gave her about the new 5 in 1 vaccine was biased.

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Thought the information her GP gave her about the new 5 in 1 vaccine was biased.

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The thing which I would say, which I probably shouldn't say is, one shouldn't trust entirely the GP or the Health Visitor because the, unfortunately they are, they have to follow guidelines which don't even necessarily agree with what they believe in but I think it's unfortunate that they are, will follow the guidelines. I was told, for example, that I was putting my daughter at great risk if I didn't give her the first set of immunisations because, given that the, we were just at the time when they are, this vaccine was being phased out and replaced by the other one, within the next 10 days, I asked, well could we wait and have the new one. Because my view, well our view was that if it, if this vaccine was being removed it, there had to be reasons for that. 

So I said, 'Well, I'd rather wait for the next 10 days.' And the, and I was told that it was not possible and I was told that the reason why it was not possible was because I was putting my daughter at great risk of catching diphtheria within the next 10 days if she didn't have the vaccine. Which I think is, is not right. Because of course that's not the reason why the GP wanted her to have the vaccine. The reason was that, it was changing in 10 days and until then he had to vaccinate a number of people and he just wanted to get it done. And so I, this made me feel a little bit ill at ease and so it was not right. To wave the risk of disease and to try to convince me that I was being irresponsible and putting her at risk.

Some parents took on board information from health professionals as part of their information seeking process but they personally believed that information from health professionals was unlikely to be objective and likely to be leaning strongly in favour of immunisation. A small number personally believed that the general practice team could not give unbiased information about immunisations because they were obliged to follow the Department of Health guidelines. As mentioned above, there is a considerable amount of research evidence to suggest that vaccines are safe and effective.

 

Believed GPs cannot give unbiased information about immunisations because they need to follow the...

Believed GPs cannot give unbiased information about immunisations because they need to follow the...

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Mother' So there is information out there but it does mean trawling through the Net.

Father' You wouldn't ask your doctor because'

Mother' No.

Father' As far as we're concerned your doctors are paid by the pharmaceutical companies and they cannot give you an unbiased opinion or an unpolitical answer to any of the questions that you might raise, towards the safety of vaccination.

Mother' Yeah taking the decision not to vaccinate does require you to be very, very strong and I'd say to any parent who takes that decision, 'You're not going to get an easy ride from the medical profession'. And I also am aware that there are some practices in some parts of the country that won't register unvaccinated children. So that's another'

Father' And if you refuse,  they strike them off their lists because it's bringing their vaccination levels down which affects their targets for money that's given to them by the pharmaceutical companies.

Mother' That's sad to say, it's not paranoia. We've talked to too many people and'

Father' It's documented.

Mother' There's an awful lot of, and unearthed a lot of information that does suggest that a lot of this is related to finance. And I find that a sin, that our children's health is being sacrificed on the altar of hard cash. I think that's just terrible. So I think that it needs a good wake up call. But my husband is right you won't get this sort of information from'

Father' Your doctor

Mother' Or you are unlikely to. There are one of two full star doctors out there, if you're lucky enough to find one. We did have a superb GP. Sadly we don't have him anymore.

But I think parents need to prioritise and look at it a bit more and question, question the medical profession. They're only going to listen if enough people question them and present them with reasonable questions and say, 'Well, why can't we do this', and 'We're not happy about this'. I think as long as everyone just trots off with this doctor knows best attitude, at the moment, it's not a good, I don't think it's a good attitude to have.

Do doctors get paid for immunisations?
In the NHS, childhood immunisations have been part of the service that GPs are contracted to provide, and they do not get paid extra for each child who is immunised. There is a scheme to give general practices small additional payments if they meet certain targets set by the Department of Health, and the targets include childhood immunisations. The money from these bonuses goes into the practice account and is not given to an individual doctor or nurse. Childhood vaccines are bought from pharmaceutical companies by the Department of Health and distributed at no cost to the general practices. The arrangements for adult vaccines, for example the annual influenza campaign (flu vaccine), and for travel immunisations are different, and there is a more direct link between the number of immunisations given and the money earned by the practice. Doctors are paid for immunisations given privately outside the NHS.

Last reviewed October 2015.
Last updated July 2013

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