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Public health policy and practice
Low immunisation uptake: Is the process the problem?
  1. Peter M Harringtona,
  2. Catherine Woodmanb,
  3. William F Shannona
  1. aDepartment of General Practice, Royal College of Surgeons in Ireland, Mercer's Health Centre, Dublin, bDepartment of Management and Social Sciences, Queen Margaret College, Edinburgh
  1. Dr Harrington, The Palms, The Avenue, Gorey, Co Wexford, Ireland

Abstract

OBJECTIVE To examine mothers' satisfaction with the process of immunisation and its possible contribution to suboptimal immunisation uptake.

DESIGN In depth interviews with mothers.

SETTING Two Community Care Areas, Dublin city, Ireland.

PARTICIPANTS In depth interviews of 23 mothers of children 1–2 years old, recruited purposively from a birth cohort born in 1994.

MAIN RESULTS Mothers preferred general practice to Health Centre immunisation (11:5) for predominantly emotional compared with practical reasons (4:1). Health Centre immunisation was seen, at times, as unacceptably rough and inhuman. Many mothers experienced severe emotional distress at the prospect of inflicting the pain of immunisation on their babies. The non-empathic stance of some immunising doctors was unacceptable to mothers. They valued attempts by health professionals to acknowledge the pain of immunisation and to engage with their baby. Adverse experiences contributed to deferral of future visits and to defaulting behaviour.

CONCLUSIONS Low empathy mass immunisation in clinic type settings may be unacceptable to mothers in the 1990s, and may in part explain suboptimal uptake in health care systems that use such clinics.

  • immunisation
  • health behaviour
  • immunisation uptake

https://doi.org/10.1136/jech.54.5.394

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    Footnotes

    • Funding: the authors wish to thank the following for their financial support of this study: The Health Research Board, The Department of Health and The General Practice Unit, Eastern Health Board.

    • Conflicts of interest: none.