Qualitative analysis of determinants of measles, mumps, rubella vaccine uptake in European parents

BackgroundParental concerns about measles, mumps and rubella (MMR)vaccination negatively influence decision to vaccinate theirchildren, this leading to the recently reported vaccine coveragedrop in Europe. The ESCULAPIO project, funded by theItalian National Centre for Disease Prevention and Control ofthe Ministry of Health (CCM), is investigating the main factorsunderlying decisions on vaccinations, in order to implementtargeted campaigns and plan effective strategies.MethodsA systematic literature review was carried out on studiesdescribing the determinants underlying MMR vaccinationuptake in European parents.ResultsA total of 45 studies were included in the analysis. The mostcommon factors related with MMR vaccine uptake wereknowledge, beliefs, perceptions on vaccines and diseases,reported in 44,4% of the articles. Parents showed doubts onvaccine efficacy, safety, side effects, while in other studiespositive beliefs and perceptions were reported. Attitudes/behaviours were often determinants of the uptake as well asdemographic factors (40%). While higher no. of children inthe household, lower income, temporary or lacking employment,and non-regular marital status were generally a barrierfor vaccination, education level and house tenure werecontradictory. Information source/advice and influence ortrust of other people, institutions, media were often reported(31,1% and 17,8% respectively), but a clear direction was notshowed.ConclusionsThese preliminary findings showed that communicationstrategies should provide parents with clear messages onvaccines and preventable infectious diseases, in order to buildright knowledge and create correct beliefs and behaviours.Communication should be addressed mainly to more disadvantaged,larger and non-regular families. A quantitativeanalysis is been currently carrying out and will provide moreinformation on the direction of the effect of the differentfactors