title: Reasons for non-uptake of measles, mumps, and rubella catch up immunisation in a measles epidemic and side effects of the vaccine.
abstract: OBJECTIVE
  To investigate the reasons for poor uptake of immunisation (non-immunisation) and the possible side effects of measles, mumps, and rubella vaccine in a catch up immunisation campaign during a community outbreak of measles.
  
  
  METHODS
  Descriptive study of reasons for non-immunisation and retrospective cohort study of side effects of the vaccine.
  
  
  METHODS
  Secondary schools in South Glamorgan.
  
  
  METHODS
  Random cluster sample of the parents of 500 children targeted but not immunised and a randomised sample of 2866 of the children targeted.
  
  
  METHODS
  Reasons for non-immunisation; symptoms among immunised and non-immunised children.
  
  
  RESULTS
  Immunisation coverage of the campaign was only 43.4% (7633/17,595). The practical problems experienced included non-return of consent forms (6698/17,595), refusal of immunisation (2061/10,897 forms returned), and absence from school on day of immunisation (1203/8836 children with consent for immunisation). The most common reasons cited for non-immunisation were previous measles infection (145/232), previous immunisation against measles (78/232), and concern about side effects (55/232). Symptoms were equally common among immunised and non-immunised subjects. However, significantly more immunised boys than non-immunised boys reported fever (relative risk 2.31 (95% confidence interval 1.36 to 3.93)), rash (2.00 (1.10 to 3.64), joint symptoms (1.58; 1.05 to 2.38), and headache (1.31 (1.04 to 1.65)).
  
  
  CONCLUSIONS
  Many of the objections raised by parents could be overcome by emphasising that primary immunisation does not necessarily confer immunity and that diagnosis of measles is unreliable. Measles, mumps, and rubella vaccine is safe in children aged 11-15.
authors.affiliation: Public Health Laboratory, Service Communicable, Disease Surveillance Centre, Welsh Unit, Cardiff.
authors.forename: R J
authors.initials: RJ
authors.lastname: Roberts
authors.forename: Q D
authors.initials: QD
authors.lastname: Sandifer
authors.forename: M R
authors.initials: MR
authors.lastname: Evans
authors.forename: M Z
authors.initials: MZ
authors.lastname: Nolan-Farrell
authors.forename: P M
authors.initials: PM
authors.lastname: Davis
mesh_terms: D000293:Adolescent; D001294:Attitude to Health; D002648:Child; D015331:Cohort Studies; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007117:Immunization, Secondary / Q000706:statistics & numerical data*; D008297:Male; D008457:Measles / Q000453:epidemiology / Q000517:prevention & control*; D008458:Measles Vaccine / Q000009:adverse effects; D022542:Measles-Mumps-Rubella Vaccine; D009108:Mumps Vaccine / Q000009:adverse effects; D010290:Parents / Q000523:psychology; D010342:Patient Acceptance of Health Care; D011897:Random Allocation; D012189:Retrospective Studies; D012411:Rubella Vaccine / Q000009:adverse effects; D011795:Surveys and Questionnaires; D017778:Vaccines, Combined / Q000009:adverse effects; D014852:Wales / Q000453:epidemiology
chemical_list: D008458:Measles Vaccine; D022542:Measles-Mumps-Rubella Vaccine; D009108:Mumps Vaccine; D012411:Rubella Vaccine; D017778:Vaccines, Combined