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Health visitors' concerns undermine GPs over MMR

Health visitors are undermining GPs' efforts to persuade parents over MMR vaccination by voicing their own concerns about the jab, a Government-funded study suggests.

Research by the Scottish Executive's health department revealed health visitors experience 'discernable tension' between their duty to 'actively encourage' MMR uptake and to support informed choice.

They tended to share concerns of more affluent parents over the triple-vaccine while promoting it to parents from lower socio-economic groups, the study found.

Parents also echoed GPs' concerns about target payments by revealing they felt 'anxiety' over the financial incentives for giving the vaccine.

GP representatives called for the UK's four chief medical officers to resign over the target payment system at this month's annual LMC conference.

The study presented to the Scottish Executive's Health Services Research Committee last month analysed health professional and patient views on MMR from 20 interviews with GPs and six health

visitor/practice nurse focus groups held between 1999 and 2001.

GPs and health visitors said they thought parents viewed GPs as 'experts' on the jab, but health visitors believed they were trusted more.

'Parents experienced tensions in their relationships with health professionals and felt their concerns were often dismissed, information concealed from them and compliance expected,' the study authors from the universities of Stirling and Abertay Dundee said.

GPs' responses revealed 'pressing concerns' over the information available about MMR controversies and how target setting was seen to

affect their clinical judgment.

RCGP immunisation spok-esman Dr George Kassianos said GPs could not expect health visitors to speak 'with one voice' on MMR. But Dr Kassianos, a GP in Bracknell, Berkshire, reaffirmed no study had shown an association between MMR and autism or bowel disease in children. 'This is the message health visitors need to put to parents.'

The findings come amid an outbreak of measles and mumps in Somerset, where uptake of MMR in two-year-olds has fallen to 80 per cent. Five cases of mumps have been reported from two towns this month, with further isolated cases of mumps and measles.

MMR uptake for the UK for the quarter ending December 2002 was the lowest ever at 81 per cent.

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