title: Risk factors for undervaccination against measles in a large sample of preschool children from rural Bavaria.
abstract: BACKGROUND
  Due to insufficient vaccination rates, measles outbreaks still pose a threat to public health in Germany. The purpose of this study was to identify risk factors for undervaccination against measles.
  
  
  METHODS
  Datasets from two cross-sectional surveys were analyzed by logistic regression models. The surveys had been done prior to and after an intervention aiming to raise measles, mumps, and rubella vaccination rates among children entering primary school in five Bavarian counties. Subjects were 9,582 children aged 6 to 7 years and their parents.
  
  
  RESULTS
  Main independent predictors of non-immunization were doctors advising against vaccination (OR 84.8; 95% CI 19.9-360.4), doctors abstaining from advice (OR 6.3; 95% CI 4.8-8.4), and parental reservations due to alternative health beliefs (OR 27.9; 95% CI 17.6-44.1).
  
  
  CONCLUSIONS
  Doctors advising against measles vaccination and doctors not giving any advice proved to be important risk factors for childhood undervaccination against measles. Future strategies to increase measles vaccination rates in Germany should focus more on family doctors.
authors.affiliation: Postgraduate Program in Public Health, Ludwig Maximilian University School of Medicine, Marchioninistrasse 15, D-81377 Munich, Germany. apzucs@hotmail.com
authors.forename: A P
authors.initials: AP
authors.lastname: Zucs
authors.forename: A
authors.initials: A
authors.lastname: Crispin
authors.forename: E
authors.initials: E
authors.lastname: Eckl
authors.forename: R
authors.initials: R
authors.lastname: Weitkunat
authors.forename: U
authors.initials: U
authors.lastname: Schlipköter
mesh_terms: D000328:Adult; D002648:Child; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D017589:Immunization Programs; D007115:Immunization Schedule; D008297:Male; D008457:Measles / Q000517:prevention & control*; D008459:Measles virus / Q000276:immunology; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage*; D009107:Mumps / Q000517:prevention & control; D009109:Mumps virus / Q000276:immunology; D012307:Risk Factors; D012409:Rubella / Q000517:prevention & control; D012412:Rubella virus / Q000276:immunology; D012424:Rural Population; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D022542:Measles-Mumps-Rubella Vaccine