Journal of Pediatrics
Volume 165, Issue 5, p879-1072 November 2014
http://www.jpeds.com/current

Vaccine promotion messages may not encourage vaccination
Helen Campbell, MSc
Public Health England
Helen Bedford, PhD
UCL Institute of Child Health, London, United Kingdom
DOI: http://dx.doi.org/10.1016/j.jpeds.2014.08.017
Commentary
Vaccination resistance and distrust emerged early and have coexisted ever since. Parents may be selective about, defer, or immunize despite having concerns.1 There is no clear evidence of increasing immunization hesitancy, however. In the United Kingdom, for example, vaccination is at its highest level, including MMR coverage. Setting aside practical barriers to vaccination, no distinct division exists between those choosing or declining vaccines.1 Multiple factors influence this decision and evidence for interventions reducing vaccine refusal or hesitancy is limited.2 In the study by Nyhan et al, none of the four MMR-related messages increased parental intent to vaccinate, although details of their children’s age (and thus MMR relevance) were missing. The study suggested that some interventions, although better informing, may increase safety concerns and reduce intent to vaccinate. In reality, multilayered (as opposed to single fact) information provision is more typical, with individual access determined by personal need. Health professionals are key,3 and the resultant interactive process can better direct to appropriate resources and allows tailored discussion. What is clearly needed, however, is adequate premarket testing with outcome measures that capture impact on knowledge and on intended behavior.