Second dose of measles, mumps, and rubella vaccine: questionnaire survey of health professionals

doi:10.1136/bmj.322.7278.82

BMJ 2001;322:82-85 ( 13 January )

Primary care

Second dose of measles, mumps, and rubella vaccine: questionnaire survey of health professionals

Marko Petrovic, specialist registrar in public health medicine, ^a Richard Roberts, consultant in public health medicine, ^a Mary Ramsay, consultant epidemiologist. ^b

^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{at}nwales-ha.wales.nhs.uk

Objective: To determine the knowledge, attitudes, andpractices among health professionals regarding the measles, mumps,and rubella (MMR) vaccine, particularly the seconddose.
Design: Self administered postal questionnairesurvey.
Setting: North Wales Health Authority,1998.
Participants: 148 health visitors, 239 practice nurses,and 206 generalpractitioners.
Main outcome measures: Respondents' views on MMR vaccination, includingtheir views on the likelihood of an association with autism andCrohn's disease and on who is the best person to give advice toparents, whether they agree with the policy of a second dose ofthe vaccine, and how confident they are in explaining the rationalebehind the seconddose.
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 professionalsnominated health visitors as the best initial source of adviceon the second vaccine. 61% of health visitors (86/140), comparedwith 46% of general practitioners (73/158), reported feeling veryconfident about explaining the rationale of a two dose scheduleto a well informed parent, but only 20% (28/138) would unequivocallyrecommend the second dose to a wavering parent. 33% of the practicenurses (54/163) stated that the MMR vaccine was very likely orpossibly associated with Crohn's disease and 27% (44/164) thatit 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 receivedthe Health Education Authority's factsheet on MMRimmunisation.
Conclusions: Knowledge and practice among health professionalsregarding the second dose of the MMR vaccine vary widely. Manyprofessionals are not aware of or do not use the good writtenresources that exist, though local educational initiatives couldremedythis.

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