title: Parental decision-making in uptake of the MMR vaccination: a systematic review of qualitative literature.
abstract: BACKGROUND
  Controversy has surrounded MMR vaccination in the aftermath of Wakefield's 1998 paper suggesting links between MMR and the development of pervasive developmental disorder in children. The paper sparked off media debate and contributed to a lack of parental trust in health-care providers and reduction in MMR uptake. This review aims to identify and evaluate research on the subject, with a view to present the reasons behind, and influences on parental decision-making in relation to MMR.
  
  
  METHODS
  Systematic search strategy identified 14 relevant papers on which thematic analysis was performed.
  
  
  RESULTS
  Themes identified were categorized as follows: perceptions of risk; roles and responsibility; experience and knowledge. There were limited changes in parental decision-making factors over the time period despite an increase in uptake. Many studies fail to differentiate between accepters and rejecters, making it difficult to draw out clear conclusions.
  
  
  CONCLUSIONS
  Policymakers need to adapt information provided to address these concerns. Future research should focus more on distinguishing between accepters and rejecters to determine which factors can alter outcome.
authors.affiliation: School of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh EH16 4TJ, UK.
authors.forename: N
authors.initials: N
authors.lastname: Allan
authors.affiliation: Centre of Population Health Science, University of Edinburgh, Edinburgh EH8 9AG, UK.
authors.forename: J
authors.initials: J
authors.lastname: Harden
mesh_terms: D003657:Decision Making; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D022542:Measles-Mumps-Rubella Vaccine; D010290:Parents / Q000523:psychology*; D010342:Patient Acceptance of Health Care
chemical_list: D022542:Measles-Mumps-Rubella Vaccine
keywords: MMR; decision making; parents; qualitative systematic review