Re: Measles: neither gone nor forgotten
We work as GPs (one of us (JS) for over 33 years) in a practice comprised mainly of patients belonging to the orthodox Jewish community of north London referred to in your editorial Measles:neither gone nor forgotten (BMJ 2018;362:k3976). I discuss immunisation with these patients on a daily basis and must disagree with the assertion that the cause of the poor immunisation uptake is due to access problems. This assertion is based on the paper by Letley L, Rew V, Ahmed R, et al (Vaccine 2018 Jul 25;36(31):4687-4692. doi: 10.1016/j.vaccine.2018.06.028. Epub 2018 Jun 23) which relies heavily on information obtained from questionnaires and interviews with parents.
Access to immunisations has always been good in this area, whether at GP surgeries, child health clinics and other facilities, as well as at a number of initiatives to facilitate ease of access over the years. I am aware that parents have become wary of discussing with healthcare professionals their reasons for not vaccinating, and fall back on the excuse of lack of access. This will be reflected in any research done with this community. Even when offered on-the-spot immunisation during a consultation the refusal rate is high. Refusal is for a variety of reasons, including what your editorial terms ‘antivaccination sentiments’, but is not due to lack of access.
Competing interests: No competing interests