Pareek M, Pattison H M
Department of Primary Care and General Practice, University of Birmingham Medical School.
Br J Gen Pract. 2000 Dec;50(461):969-71.
In the light of sub-optimal uptake of the measles, mumps, and rubella (MMR) vaccination, we investigated the factors that influence the intentions of mothers to vaccinate.
A cross-sectional survey of 300 mothers in Birmingham with children approaching a routine MMR vaccination was conducted using a postal questionnaire to measure: intention to vaccinate, psychological variables, knowledge of the vaccine, and socioeconomic status. The vaccination status of the children was obtained from South Birmingham Child Health Surveillance Unit.
The response rate was 59%. Fewer mothers approaching the second MMR vaccination (Group 2) intended to take their children for this vaccination than Group 1 (mothers approaching the first MMR vaccination) (Mann-Whitney U = 2180, P < 0.0001). Group 2 expressed more negative beliefs about the outcome of having the MMR vaccine ('vaccine outcome beliefs') (Mann-Whitney U = 2155, P < 0.0001), were more likely to believe it was 'unsafe' (chi 2 = 9.114, P = 0.004) and that it rarely protected (chi 2 = 6.882, P = 0.014) than Group 1. The commonest side-effect cited was general malaise, but 29.8% cited autism. The most trusted source of information was the general practitioner but the most common source of information on side-effects was television (34.6%). Multiple linear regression revealed that, in Group 1, only 'vaccine outcome beliefs' significantly predicted intention (77.1% of the variance). In Group 2 'vaccine outcome beliefs', attitude to the MMR vaccine, and prior MMR status all predicted intention (93% of the variance).
A major reason for the low uptake of the MMR vaccination is that it is not perceived to be important for children's health, particularly the second dose. Health education from GPs is likely to have a considerable impact.
鉴于麻疹、腮腺炎和风疹（MMR）疫苗接种率未达最佳水平，我们对影响母亲们疫苗接种意愿的因素进行了调查。
采用邮寄问卷对伯明翰市300名孩子即将进行常规MMR疫苗接种的母亲进行横断面调查，以测量：疫苗接种意愿、心理变量、疫苗知识及社会经济状况。孩子的疫苗接种状况来自南伯明翰儿童健康监测部门。
回复率为59%。与第一组（孩子即将接种第一剂MMR疫苗的母亲）相比，第二组（孩子即将接种第二剂MMR疫苗的母亲）中打算带孩子接种该疫苗的母亲更少（曼-惠特尼U检验=2180，P<0.0001）。第二组对MMR疫苗接种结果表达了更多负面看法（“疫苗结果信念”）（曼-惠特尼U检验=2155，P<0.0001），比第一组更有可能认为该疫苗“不安全”（卡方检验=9.114，P=0.004）且很少有保护作用（卡方检验=6.882，P=0.014）。提及最多的副作用是全身不适，但29.8%的人提到了自闭症。最受信任的信息来源是全科医生，但关于副作用最常见的信息来源是电视（34.6%）。多元线性回归显示，在第一组中，只有“疫苗结果信念”能显著预测接种意愿（方差的77.1%）。在第二组中，“疫苗结果信念”、对MMR疫苗的态度及之前的MMR疫苗接种状况均能预测接种意愿（方差的93%）。
MMR疫苗接种率低的一个主要原因是人们认为其对儿童健康不重要，尤其是第二剂。全科医生开展的健康教育可能会产生相当大的影响。
