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Immunisation

Making the decision

The decision about whether or not to immunise their child is for some parents one of the most difficult they have to make in their child's first two years of life. Most parents who've had to make a decision about MMR over the last ten years will have felt some level of concern as to whether they are doing the right thing. Many will have felt confused and anxious when faced with conflicting information, scaremongering tactics in the media and rumours of conspiracy theories. There is now a huge body of research evidence available which indicates the effectiveness and safety of the vaccines.

Parents who had made a decision about MMR in the last few years said it was now slightly easier to make the decision because so much more evidence is now available to reassure them. 

 

It is easier to make the decision now than two years ago, now more evidence is available.

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I certainly don't blame people who don't immunise their children because it's, it's a very difficult decision to make. Especially in the climate that we've just kind of been through. I felt very lucky at the time that I hadn't had my child two years earlier for example. Because I really wouldn't have known what to do for the best and I would really, really have worried about it. And I actually remember getting very cross around that time when everybody, all my friends with children the same age were worrying about what to do and I got really cross with people who didn't have children of that age, at that time telling me what they thought we should do because they don't know what it's like to bring, to be making that decision at that time.  

And I would not have given him some of, you know, one or two of those things perhaps if, if there was more of an atmosphere of fear about it, and mistrust. And, but, I kind of came to that stage with my child just at the point where was a lot of information. It was, it was easy to get and I felt, I felt I could trust the information and I was making the right decision and I, once I made that decision I just wanted to get it over and done with actually. I just really wanted to, I remember making the decision and then things happening and I wasn't able to go to the doctor's to do it for a few weeks and just really thinking, I just want to get this done because we've made the decision now, and everything was fine.    
 

Some people have strong views on MMR - either in favour of immunisation or against it. As an outsider, it may seem easy to make a rational and objective assessment of the arguments involved but when a decision is required that will affect your child it can be a lot harder.

Since these interviews were made, the research that suggested a connection between autism and MMR vaccine has been completely discredited (Andrew Wakefield's has since been struck off as a doctor in the UK) and the original paper has been retracted by the Lancet, on the grounds that several elements of the paper are incorrect and that some of the claims by the authors were proven to be false (Lancet, 6 Feb 2010, vol 375, issue 9713, page 445. Retraction – Ileal-lymphoid-nodular hyperplasia, non-specific colitis and pervasive developmental disorder in children). 

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. 

Some parents said that the MMR decision had been very straightforward, generally these parents had a clear view on the value of immunisations for their child.

 

Making the decision wasn't difficult for her because she had lived in Africa and had seen what...

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I guess partially because I've worked in Africa and there are, there's a very low rate of vaccination in the country that I was working in [country] and you know, I saw lots of people with polio for example, you know, they couldn't walk and, and you know, it's such a common occurrence to see someone with polio that you know, “Oh yeah that person has polio, that person has polio.” And, it just, and also, because I was working with, in education for women I also learned that there's so many children, you know, are dying of things like measles and, you know, lots of these preventable diseases so I think that made me quite pro-vaccination, because I, in fact I think vaccinations are miracles.

So I guess for me making the decision to immunise my children wasn't a difficult decision because I think immunisations are wonderful, and, and I know, I know that, that there can be side effects but I think if you look at the statistics of if you didn't get the immunisation and what are the chances of becoming ill with that, of the child becoming ill with that disease, versus if you look at the statistic of if you get the immunisation what is the chance of having a side effect. Then I would think that it's much riskier not to be immunised.

 

She didn't think for too long about MMR because she believed the benefits of immunisation...

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Well, I'm not sure that I, there was really a decision to make. I didn't really waver for very long because I think I just believe that vaccinations are a good thing and that the risks of not having a child vaccinated vastly outweigh the risks of anything that might occur from the, the vaccination. And I think that in everything you do in life carries a certain risk and you've got to live with that really, you can't expect everything you do to be risk free.  

So I, you know, I was aware that there's, there's probably all sorts of research out there claiming that, you know, this side-effect and that side effect but every time we take drugs there are side-effects and people do it all the, all the time. And I think there is a little bit of slight unwarranted fear about injections just because of all the publicity and because of the, particularly obviously around MMR.

And actually for that reason I didn't really do any reading or [laughs] I didn't really want to look into it because I knew if you start looking you'll obviously find people who've written a report saying, link, you know, there's a link with autism or other sort of risks. And I knew I was going to do it anyway so there was no point in frightening myself or focusing on sort of tiny risks when actually the, I knew, you know, that the benefits were gong to massively increase that massively over-ride that. So I didn't really, I didn't really think about it too much.

 

After learning more about MMR and the latest thoughts surrounding the vaccine, they felt able to...

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I always thought that immunisation is quite a good idea, it makes a lot of, a lot of sense, but obviously there's been a lot of stuff in the press so I wanted to, to just what the latest thinking was on it. The early ones, I was actually more concerned about her having a needle put in her and I found that side of things quite upsetting because it just seems so small and fragile at that stage and they're not, they haven't had as much controversy as the MMR. So, that wasn't really a big decision for me. But when it came to the MMR we looked into it a lot more and talked to people and made our decision just based on weighing up the pros and cons really.

So, the information sought, you said you talked to people. Who did you talk to?

A lot of it was just friends because they'd all, because a lot of our friends had made it through having the baby, they've been going through the same sorts of decisions at the same time. So just finding out really what they had found out. Reading the leaflet that we got from the GP. Had a look on the Internet as well just to see, to see what the latest thoughts were. And I think really, for us, it was just a question that, it looked, it looked like the actual illnesses probably presented a greater risk than a risk associated with the jabs or seemed to be associated with the jabs.

And, particularly with the MMR there was a lot controversy around autism about'

Yeah.

How did you feel about that?

It, it was a concern and obviously if you focus on the autism side of things, you know, it's, it, it's not a nice thing to have by any means, and it is serious. But having said that it didn't look that the research that had been done was particularly conclusive and especially the timing with us, it was actually, the main bit of research was being discredited. So, you know, we just factored that in. And also we were quite worried because in the area that we live in quite a lot of people weren't having the MMR and it seemed that actually the risk of getting, you know, measles, mumps and rubella, was going to increase, so all the more need for the injection.

Gathering Information
It is absolutely right and normal that parents are concerned about the optimal health of their children and it is important that parents seek reliable scientific evidence on which to base their decisions and there is now a mass of this information available.

Most parents sought information to investigate further the issues that had been discussed in the media, either by talking to friends and other parents, to health professionals, looking on the internet or finding the source of the research findings in medical journals. (See 'Information for Making Decisions' section). Several parents thought it was important to gather information from more than one source and to get as broad a view as possible.   

Some of these parents said they didn't look for too much information because they felt it would be confusing and they were already fairly convinced that they were going to immunise their child. 

Others had talked to many different people and gathered a lot of information before they felt able to make a decision. 

 

Making the decision about her son's MMR has been the hardest decision she has had to make as a...

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I think this decision is the hardest decision I've had to make as a parent. I only have one son and I had him quite old. I was thirty-eight when he was born. I lived a lot of my life. I've worked and I'd always felt like I, yes, you know, most of the time I know what I am doing. I'm a teacher. I'm not, you know, I'm not a head of department or head of my subject or anything. I'm a jobbing teacher. I like my work. I'm fine thank you very much.

And you have a baby and you haven't got a clue what you are doing. You know, no one can tell you how your life will change. I'm sure every, every new parent's life changes in different ways. And you're constantly having to make decisions about everything' about what time to, to feed; what time to change a nappy; what, should I put him down to sleep; or he is crying should I pick him up and; should I give him the vaccination and, and, I think the first couple of vaccinations were fine because, you know, that's what's done and you've got so many decisions to make. And, and now because he's slightly older and I'm slightly, I mean it's, it's still you know, it's still a minefield being a parent. You are constantly unsure whether you're doing the right thing or not but I'm slightly more sure of what I am doing now. So I can, I can make a decision about this and hopefully feel at the end my decision is, is the right one. I'm feeling more confident as a parent now but it, it is the hardest decision that I've ever had, had to make regarding my son.
 
 

She talked to a lot of people and gathered a lot of information before making a decision to give...

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But it did become, you know, sort of really anxiety-inducing thing for the whole of the first year. And all of my friends who had children that age were, it was kind of, the main topic of conversation was, 'What have you read? What have you seen? Who have you spoken to? Have you got anything that's going to sway it one way or the other?' And I think the hardest thing, particularly with the MMR, was that you felt whatever you did you were endangering your child's sort of well-being. And that's, you know, which was what made it such an incredibly tough decision. Because it wasn't just, 'Is it going to be good for them or not so good for them?' It was kind of like, 'Am I being socially responsible as far as, you know, everybody else goes? And am I risking my child's life and health and all the rest of it in order to be socially responsible? And if I don't immunise, then am I risking my child's life that way round as well?' 

So it was a kind of, you know, it was a really, really big issue. I then basically read everything I could get my hands on and spoke to anybody who could possibly bear to have another conversation about immunisation with me. And in the end I didn't feel that the evidence or the research against it at the time was strong enough to warrant me not doing it. And I, you know, I then thought about having them all done individually, and just thought, 'Actually, I know I'll end up doing half and not doing the other half, and then I might as well not have started in the first place'. So we decided just to go for it and I was holding my breath and praying that it was all going to be all right.

 

She talked to three or four different doctors before deciding to give her daughter MMR.

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And then I think when I came to the booster one at 8 months that was fine, I just went ahead and did it. But I did start to worry after that when the 13 months sort of started to come up that the MMR thing, you know, this whole big debate. So I think basically I did a lot of reading, I spoke to a lot of people, spoke to about three or four different doctors, and I was very, very tempted to go for the single jabs, and I was prepared to pay the money because I was just too, you know, too concerned about the, the link with autism. But then, I don't know what it was, it was almost as if there was something inside me that suddenly just decided to get, to get her done. 

And I'd spoken to a very good private doctor who'd convinced me that actually there was nothing wrong and he would go ahead and do the triple jab. So I went ahead and I booked her in and I got the, the injection done. And then literally the next afternoon at nursery there was a mumps, or was it, no, there was a measles case. And, and I don't know why I, but I just, you know, there was obviously something inside me that I had to do it that particular day, and then the next day this measles case came up. And, and she was, you know, she was fine, she hasn't, she hasn't got it. And so far she hasn't shown any strange behaviour, things towards the, the MMR. So I think in the end I was quite happy that I made the decision because, you know, having measles obviously is ten times worse.

When making immunisation decisions 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.

Some mothers said it had been one particular piece of information, or talking to a health professional or a friend, which had swayed their final decision. 

 

Talking to a friend in America helped her to make a final decision.

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So, I talked to my GP, who I've always trusted implicitly. We have a very good relationship. And she said that the MMR was, was safe as far as she knew, and gave me some anecdotal evidence. And that was the first time I thought, 'But you work for the NHS. I bet that's not true what you've told me'. Which now, a year after he had the MMR, it's quite a bizarre thought to think that I would have thought that about my GP. But then I moved on from her to my consultant, who I see about my condition, and I just happened to drop in that we were thinking of giving our son the MMR, and what did he think? And he was actually very, very full in his opinion and said, 'I think it's worse if you don't give him the MMR than if you do. I think the risks are greater'. I came out from seeing him, and had the same feeling of, 'Yes, but you work for the NHS'. Which even now I can't really believe that I thought. But because potentially I was going to damage my son, then I didn't trust anybody really. So from, from that information then I read things in the paper, which I read and then felt completely unsatisfied after I'd read, because I didn't feel any wiser really. So then I went on to the Web, and that was equally opposing views, and I was left thinking, 'Well, I've got to make the decision myself'.

And I talked to friends, who said that if their child had been a girl, then, yes, they would have immunised. But because all three of my friends had boys, then they said, no, they weren't, they were going to go for the individual jabs. So I then spent time looking for clinics who would immunise, and I found one that seemed a possibility. The cost was phenomenal. I think it was about '150 per injection. And then it, because of the time we wanted to have it done, then there was a, a shortage of the mumps vaccine, so we wouldn't be able to have that anyhow. So it seemed, you know, when I found that out, then for a few weeks we toyed with the idea that it would probably be best to give him the individual vaccinations.

But also, amongst my group of friends then I seemed to be the only person who was vaguely concerned about the injection and not having it on time. So my friends were saying, 'Oh, yes, we, yes, we really must look into that'. And I was thinking, 'But if I delay it any longer maybe he's going to get the infections anyhow'. So I felt there was a bit more, I needed to be a bit quicker really in making my decision.  

So I think I then phoned a friend in the States to say, 'Well, look, we're thinking about getting these injections done individually'. And she said, 'Right, yes, there has been quite a lot of, lot of stuff about that in the press in England'. She said, 'I only know that if I hadn't given my child the immunisation, then she wouldn't have been allowed to go to school in the States'. And I don't know why that piece of information just switched me into thinking, 'Okay, we'll go for it'. But we decided at that point that we'd go for the MMR. I think probably what she said combined with my dissatisfaction in having the individual jabs done privately, then I think that's probably what switched my decision.

Weighing Up the Risks
After gathering information, parents were able to weigh up the risks of not immunising against the risks of potential side effects from the immunisations (see 'Weighing up the risks') and decide for themselves what was the right decision for their child. Parents stressed that however much information they gathered, ultimately the final decision was theirs and for some parents making that decision had felt like a huge responsibility.

Some parents said that once they'd made a decision they just wanted to get the immunisation done.

“It was, I suppose something that had been preying on my mind for quite a long time. But once I'd made the decision, I felt quite happy, like a weight had been lifted. I thought, “Right okay, I've made a decision. I've made it for what I believe to be good reasons so I'm just going to go with it now.”  [Interview 33 - Mother of a 17-month-old boy.]

Making decisions together
Most parents came to a joint agreement about the immunisation decisions for their children. Often mothers took the lead by gathering information and showing it to their partners. Many said it was important that they both agreed with the decision made, so that they couldn't blame each other should there be any negative consequences.

 

Explains how they made a joint decision for their premature son's MMR immunisation.

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He was, he didn't do as much research as I did. He, he sort of listened to what I said about it and made his decision. But I had to know that if anything did happen he wasn't going to turn round and blame me. Like if he felt any, any doubt to giving him MMR we weren't going to do it.  He had to be 100 per cent in his own mind that he was going to do it. But if he had any doubts I wasn't prepared to go against him on that. So it was something he agreed with. But I, I did most of the sort of, I worried about it more than him.
 

 

Last reviewed October 2015.
Last updated October 2015.

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