title: The impact of the media on the decision of parents in South Wales to accept measles-mumps-rubella (MMR) immunization.
abstract: A large measles outbreak occurred in South Wales in 2012/2013. The outbreak has been attributed to low take-up of measles-mumps-rubella (MMR) immunization in the early 2000s. To understand better the factors that led to this outbreak we present the findings of a case-control study carried out in the outbreak area in 2001 to investigate parents' decision on whether to accept MMR. Parents who decided not to take-up MMR at the time were more likely to be older and better educated, more likely to report being influenced by newspapers [adjusted odds ratio (aOR) 3·07, 95% confidence interval (CI) 1·62-5·80], television (aOR 3·30, 95% CI 1·70-6·43), the internet (aOR 7·23, 3·26-16·06) and vaccine pressure groups (aOR 5·20, 95% CI 2·22-12·16), and less likely to be influenced by a health visitor (aOR 0·30, 95% CI 0·16-0·57). In this area of Wales, daily English-language regional newspapers, UK news programmes and the internet appeared to have a powerful negative influence. We consider the relevance of these findings to the epidemiology of the outbreak and the subsequent public health response.
authors.affiliation: Public Health Wales Communicable Disease Surveillance Centre,Temple of Peace and Health, Cathays Park, Cardiff,UK.
authors.forename: S
authors.initials: S
authors.lastname: Walsh
authors.affiliation: Public Health Wales Communicable Disease Surveillance Centre,Temple of Peace and Health, Cathays Park, Cardiff,UK.
authors.forename: D Rh
authors.initials: DR
authors.lastname: Thomas
authors.affiliation: Public Health Wales Communicable Disease Surveillance Centre,Temple of Peace and Health, Cathays Park, Cardiff,UK.
authors.forename: B W
authors.initials: BW
authors.lastname: Mason
authors.affiliation: Public Health Wales Communicable Disease Surveillance Centre,Temple of Peace and Health, Cathays Park, Cardiff,UK.
authors.forename: M R
authors.initials: MR
authors.lastname: Evans
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D016022:Case-Control Studies; D002675:Child, Preschool; D003146:Communications Media; D004196:Disease Outbreaks; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data*; D008297:Male; D008457:Measles / Q000453:epidemiology; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage*; D010290:Parents; D010342:Patient Acceptance of Health Care; D006113:United Kingdom / Q000453:epidemiology; D014852:Wales; D055815:Young Adult
chemical_list: D022542:Measles-Mumps-Rubella Vaccine
keywords: Attitude to health; immunization; mass media; measles-mumps-rubella vaccine; parents; patients' acceptance of healthcare