Jo YarwoodDepartment of Health

Informing the public about immunisation

Frighten them – make them feel guilty!

Amuse/alarm them!

Congratulate and engage them

But first, find out what they think

•tracking•health professionals•parents

•strategic

•developmental

•pre-testing

•evaluation

Perceived severity of disease

*

Half considered swine flu to be very serious. Little change in perceived severity of other diseases over time for parents of 0-2s.

95% 93% 93% 92% 93% 91%

19% 21% 23% 24%28% 28%

24%27% 27% 29%

97% 95% 92%95%

51%

Nov 00 Nov 01 Nov 02 Nov 03 Nov 04 Nov 05 Nov 06 Nov 07 Nov 08 Feb 10

Meningitis

Septicaemia

Pneumonia

Polio

Swine flu

Diphtheria

Rubella

Tetanus

Hib

Measles

Mumps

Base: Parents of 0-2s - 2010 (1142), previous years c.1000

Base: 2010 - parents of 0-4s (1730)

The swine flu vaccine is the main concern for parents now, with MMR on a par with others in terms of perceived safety

58%48% 51% 52% 52% 51%

46% 46% 49%

29%

Pre-schoolbooster

2nd doseMMR

5 in 1vaccine

Seasonal flu TB Men C MMR Pneumo Hib/Men C Swine flu

Slight risk

Completely safe83%86%

83% 83% 82% 81% 81% 79% 78%

68%

Are immunisations safe?

Base: 2010 - parents of 0-4s

Overall levels of satisfaction are high. Parents are least likely to be totally satisfied with getting information prior to the visit and how side effects are dealt with. Parents aged 16-24 were less

satisfied, both overall and with getting information.

4% 2% 1% 2% 1%

8%3% 2% 2% 2%

10%

3%2%

11%4%

36%

26%25%

33%

33%

41%

66%69%

49%58%

Getting informationbefore the

immunisation was due

Making theappointment*

The immunisation visit* How any side effectswere dealt with after

the visit*

The immunisationprocess as a whole

Totally satisfied

Fairly satisfied

Neither satisfiednor dissatisfied

Fairly dissatisfied

Very dissatisfied

Satisfaction with the immunisation process

No differences by age of child

What influences them?

Wakefield AJ et al 1998 The Lancet 351: 637-41

“We did not prove an association between measles, mumps and rubella

and the syndrome described.”

60

70

80

90

MMR uptake

% mothers confident

MMR uptake at 16 months and proportion of mothers believing in complete or almost complete

safety of MMR vaccine

Crohn’s paper Autism paper

%

Sustained negative media reportage

Thanks to Professor Brent Taylor

Daily

Mirror

Times

Daily Telegraph Daily Star

Attitudes towards vaccination• parents of 8 – 10 year old children (2005)

• parents of 11 – 12 year old girls (2007)

• 11 – 12 year girls (2007)

• health professionals (2007)

• ongoing developmental work (e.g. advertising)

• pre-testing

• evaluation

But . . . expect the unexpected

• most girls didn’t know where their cervix was, and wherever it was, they certainly didn’t want the injection there! (The campaign strapline ‘arm against cervical cancer’ went a long way towards allaying this fear).

• you can include too much information in a leaflet. Keep it short and clear. Use other platforms for more detailed information such a factsheet, Q&A and website.

• layout and design of materials can make a big difference; we tested two leaflets with same text but different layout – some girls thought the content was different.

Leaflet

About fitness

Does communication matter?

• 2008, Romania introduced an HPV vaccine programme

• programme not supported by communications • cohort of 111,000, low acceptance • limited uptake to 2,615 doses • current plans in Romania –

• implement an information campaign and then

• re-launch the programme

• clarity

• consistency

• facts

• openness

• range of information/resources

What do parents want?

Most parents discussed 0-2s immunisations with a HP, but less so for 3-4s. HV in particular much less used by parents of 3-4s

Who do parents talk to?

77%74%

80%74%

79% 77% 76% 78% 79%85%

13%9%11%

14%9%

13%10%

15% 15%12%

Nov 00 Nov 01 Nov 02 Nov 03 Nov 04 Nov 05 Nov 06 Nov 07 Nov 08 Feb 10

Any HV GP PN Midwife

Base: Parents of 0-2s - 2010 (1142), previous years c.1000

Health professionals and the NHS remain the most trusted sources of advice on immunisation. Parents recognise that family and friends may not give them the most accurate information.

Who do parents trust?

Base: 2010 - parents of 0-4s (1730)

14%

18%

19%

42%

54%

4%Media

Family/friends

Government

Pharmacist

NHS

GP, HV or PN

Strongly agree

Slightly agree

92%

86%

66%

58%

49%

21%

No difference by age of

child

"The irony of the Information Age is that it has given new

respectability to uninformed opinion".

John Lawson (reporter) to the American Association of Broadcast Journalists (1995).