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Logo of brjgenpracRCGP homepageJ R Coll Gen Pract at PubMed CentralBJGP at RCGPBJGP at RCGP
Br J Gen Pract. Jul 1, 2004; 54(504): 520–525.
PMCID: PMC1324804

Managing controversy through consultation: a qualitative study of communication and trust around MMR vaccination decisions

Robert McMurray, PhD, Lecturer in Organisational Behaviour
Durham Business School, University of Durham
Francine M Cheater, PhD, Professor of Public Health Nursing
School of Healthcare Studies, University of Leeds
Anna Weighall, PhD, Senior Lecturer in Psychology
School of Social Science and Law, Sheffield Hallam University
Carolyn Nelson, MSc, Prescribing Advisor
Leeds North West Primary Care Trust
Martin Schweiger, FFPHM, Consultant in Communicable Disease Control
Leeds North East Primary Care Trust
Suzanne Mukherjee, MSc, Researcher


Background: Controversy over the measles, mumps, and rubella (MMR) vaccine has reduced uptake, raising concerns of a future disease epidemic.

Aims: To explore parents' accounts of decision making relating to the MMR vaccine controversy, identifying uptake determinants and education needs.

Design of study: Qualitative interviews analysed using the ‘framework’ approach.

Setting: Five general practices in the Leeds area, 2002–2003.

Method: Sixty-nine interviews conducted with parents of children aged between 4 and 5 years, and 12 interviews with primary care practitioners, managers and immunisation coordinators serving participating sites. Participants were interviewed one-to-one in a place of their choice.

Results: The vaccination decision is primarily a function of parental assessments of the relative acceptability and likelihood of possible outcomes. For most parents the evidence of science and medicine plays little role in the decision. Although local general practitioners and health visitors are trusted information sources, the influence of primary care providers on the vaccination decision is limited by concerns over consultation legitimacy, discussion opportunity, and perceptions of financial and political partiality. Parents and practitioners identify a need for new approaches to support decisions and learning when faced with this and similar healthcare controversies. These include new collaborative approaches to information exchange designed to transform rather than supplant existing parent knowledge as part of an ongoing learning process.

Conclusion: The study identified new ways in which parents and practitioners need to be supported in order to increase understanding of medical science and secure more informed decisions in the face of health controversy.

Keywords: health services, managed care, measles-mumps-rubella vaccine, MMR vaccine, trust, vaccination

Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners
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