http://www.bmj.com/cgi/content/abstract/322/7278/82?lookupType=volpage&vol=322&fp=82&view=short
BMJ 2001;322:82-85 ( 13 January )
Marko Petrovic
a Department of Public Health, North Wales Health Authority,
Preswylfa, Mold, Flintshire CH7 1PZ, b Public Health Laboratory
Service, Communicable Disease Surveillance Centre, Colindale, London NW9 5EQ
Correspondence to: M Petrovic marko.petrovic@nwales-ha.wales.nhs.uk
Objective: To determine the knowledge, attitudes, and practices
among health professionals regarding the measles, mumps, and rubella
(MMR) vaccine, particularly the second dose.
Design: Self administered postal questionnaire survey.
Setting: North Wales Health Authority, 1998.
Participants: 148 health visitors, 239 practice nurses, and
206 general practitioners.
Main outcome measures: Respondents' views on MMR vaccination, including
their views on the likelihood of an association with autism and Crohn's
disease and on who is the best person to give advice to parents,
whether they agree with the policy of a second dose of the vaccine,
and how confident they are in explaining the rationale behind the
second dose.
Results: Concerning the second dose of the vaccine, 48% of
the professionals (220/460) had reservations and 3% (15) disagreed
with the policy of giving it. Over half the professionals nominated
health visitors as the best initial source of advice on the second
vaccine. 61% of health visitors (86/140), compared with 46% of
general practitioners (73/158), reported feeling very confident
about explaining the rationale of a two dose schedule to a well
informed parent, but only 20% (28/138) would unequivocally recommend
the second dose to a wavering parent. 33% of the practice nurses
(54/163) stated that the MMR vaccine was very likely or possibly
associated with Crohn's disease and 27% (44/164) that it was
associated with autism. Nearly a fifth of general practitioners (27/158)
reported that they had not read the MMR section in the "green
book," and 29% (44/152) reported that they had not received the
Health Education Authority's factsheet on MMR immunisation.
Conclusions: Knowledge and practice among health professionals regarding
the second dose of the MMR vaccine vary widely. Many professionals
are not aware of or do not use the good written resources that
exist, though local educational initiatives could remedy this.
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INFORMATION, DATA, AND MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR
GENERAL INFORMATION PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE
KNOWLEDGE OR OPINIONS OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED
AS PROVIDING MEDICAL OR LEGAL ADVICE. THE DECISION WHETHER OR NOT TO
VACCINATE IS AN IMPORTANT AND COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU
ALONE, IN CONSULTATION WITH YOUR HEALTH CARE PROVIDER.