title: Attitudinal and demographic predictors of measles-mumps-rubella vaccine (MMR) uptake during the UK catch-up campaign 2008-09: cross-sectional survey.
abstract: OBJECTIVE
  Continued suboptimal measles-mumps-rubella (MMR) vaccine uptake has re-established measles epidemic risk, prompting a UK catch-up campaign in 2008-09 for children who missed MMR doses at scheduled age. Predictors of vaccine uptake during catch-ups are poorly understood, however evidence from routine schedule uptake suggests demographics and attitudes may be central. This work explored this hypothesis using a robust evidence-based measure.
  
  
  METHODS
  Cross-sectional self-administered questionnaire with objective behavioural outcome.
  
  
  METHODS
  365 UK parents, whose children were aged 5-18 years and had received <2 MMR doses before the 2008-09 UK catch-up started.
  
  
  METHODS
  Parents' attitudes and demographics, parent-reported receipt of invitation to receive catch-up MMR dose(s), and catch-up MMR uptake according to child's medical record (receipt of MMR doses during year 1 of the catch-up).
  
  
  RESULTS
  Perceived social desirability/benefit of MMR uptake (OR = 1.76, 95% CI = 1.09-2.87) and younger child age (OR = 0.78, 95% CI = 0.68-0.89) were the only independent predictors of catch-up MMR uptake in the sample overall. Uptake predictors differed by whether the child had received 0 MMR doses or 1 MMR dose before the catch-up. Receipt of catch-up invitation predicted uptake only in the 0 dose group (OR = 3.45, 95% CI = 1.18-10.05), whilst perceived social desirability/benefit of MMR uptake predicted uptake only in the 1 dose group (OR = 9.61, 95% CI = 2.57-35.97). Attitudes and demographics explained only 28% of MMR uptake in the 0 dose group compared with 61% in the 1 dose group.
  
  
  CONCLUSIONS
  Catch-up MMR invitations may effectively move children from 0 to 1 MMR doses (unimmunised to partially immunised), whilst attitudinal interventions highlighting social benefits of MMR may effectively move children from 1 to 2 MMR doses (partially to fully immunised). Older children may be best targeted through school-based programmes. A formal evaluation element should be incorporated into future catch-up campaigns to inform their continuing improvement.
authors: Department of Surgery and Cancer, Imperial College, London, United Kingdom. Katrina.Brown@imperial.ac.uk
authors: Katrina
authors: K
authors: Brown
authors: Graham
authors: G
authors: Fraser
authors: Mary
authors: M
authors: Ramsay
authors: Ruth
authors: R
authors: Shanley
authors: Noel
authors: N
authors: Cowley
authors: Johan
authors: J
authors: van Wijgerden
authors: Penelope
authors: P
authors: Toff
authors: Michelle
authors: M
authors: Falconer
authors: Michael
authors: M
authors: Hudson
authors: John
authors: J
authors: Green
authors: J Simon
authors: JS
authors: Kroll
authors: Charles
authors: C
authors: Vincent
authors: Nick
authors: N
authors: Sevdalis
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