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Adverse publicity relating MMR vaccine to inflammatory bowel disease and autism in early 1998 1 resulted in parental anxiety and was reminiscent of pertussis scares in the 1970s.2 TESS HARRIS and colleagues investigated professional knowledge about contraindications to the vaccination Community practitioner 2001; 74, 2: 66-67
The Department of Health acted quickly to reassure parents about MMR vaccine safety, but between July and September 1998 there was a 1.4 per cent fall in MMR vaccine coverage in children aged 24 months, the largest drop since the programme began.3
Many studies have investigated why children are not immunised. The influential Peckham report4 found that the commonest reason given by parents for not immunising their child was that they were so advised by their doctor or health visitor. The report found confusion among health care professionals about vaccination contraindications, with GPs having lower knowledge than other professionals did. GP knowledge was strongly associated with vaccine uptake among patients.
We studied primary health care professionals' knowledge about contraindications to MMR vaccination following the MMR scare.
Methods
A questionnaire was sent to all GPs, health visitors and practice nurses in Croydon Health Authority, Surrey, in June 1998. Non-responders were re-mailed with a further questionnaire after two and four months.
The questionnaire was compiled using information contained within the immunisations `green book'.5 Respondents were asked to consider 12 clinical scenarios for MMR vaccination and choose one of six management options (see table footnotes).
The correct option was that immunisation should be recommended in all scenarios. Advice that the child should have the vaccines separately or not have MMR vaccine at all were considered incorrect responses. Professionals could also choose the option to refer to a GP or paediatrician for advice. Respondents were given a score of one for each correct answer, giving a maximum score of 12. Scores were categorised as low (0-6) and high (7-12). Statistical comparisons were made between GPs and health visitors (using chisquared and Fisher's exact test as appropriate).
Practice nurses were not included in these statistical comparisons as they are...