1. Informing the public about
immunisation
Jo Yarwood
Department of Health

2. Frighten them – make them
feel guilty!

4. Amuse/alarm them!

5. Congratulate and engage
them

7. But first, find out what they think
•tracking
•health professionals
•parents
•strategic
•developmental
•pre-testing
•evaluation

8. 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% 95% 97% 95% 93% 93% 93%
92% 92% 91%
Meningitis
Septicaemia
Pneumonia
Polio
Swine flu
51%
Diphtheria
Rubella
* Tetanus
28% 28% 27% 27% 29% Hib
23% 24% 24%
19% 21% Measles
Mumps
Nov 00 Nov 01 Nov 02 Nov 03 Nov 04 Nov 05 Nov 06 Nov 07 Nov 08 Feb 10
Base: Parents of 0-2s - 2010 (1142), previous years c.1000

10. Are immunisations safe?
The swine flu vaccine is the main concern for parents now, with MMR on a par with
others in terms of perceived safety
86% Slight risk
83% 83% 83% 82% 81% 81% Completely safe
79% 78%
68%
58%
48% 51% 52% 52% 51% 49%
46% 46%
29%
Pre-school 2nd dose 5 in 1 Seasonal flu TB Men C MMR Pneumo Hib/Men C Swine flu
booster MMR vaccine
Base: 2010 - parents of 0-4s (1730)

11. Satisfaction with the immunisation
process
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.
Totally satisfied
41%
49%
66% 58%
Fairly satisfied 69%
Neither satisfied
nor dissatisfied
36%
Fairly dissatisfied 33%
33%
26%
10% 25%
Very dissatisfied
8% 11%
3% 4%
4% 3% 2%
2% 2% 2%
2% 1% 2% 1%
Getting information Making the The immunisation visit* How any side effects The immunisation
before the appointment* were dealt with after process as a whole
immunisation was due the visit*
No differences
Base: 2010 - parents of 0-4s
by age of child

12. What influences them?

14. 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.”

15. 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
90
80 MMR uptake
%
% mothers confident
70
60
4
5
6
7
8
9
0
1
2
3
-9
-9
-9
-9
-9
-9
-0
-0
-0
-0
pr
pr
pr
pr
pr
pr
pr
pr
pr
pr
A
A
A
A
A
A
A
A
A
A
Thanks to Professor Brent Taylor

16. Times
Daily
Mirror
Daily Telegraph Daily Star

17. 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

18. 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.

19. Leaflet
About fitness

20. 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

21. What do parents want?
• clarity
• consistency
• facts
• openness
• range of information/resources

22. Who do parents talk to?
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
Any HV GP PN Midwife
85%
80% 79% 78% 79%
77% 77% 76%
74% 74%
13% 14% 13% 15% 15%
11% 10% 12%
9% 9%
Nov 00 Nov 01 Nov 02 Nov 03 Nov 04 Nov 05 Nov 06 Nov 07 Nov 08 Feb 10
Base: Parents of 0-2s - 2010 (1142), previous years c.1000

23. Who do parents trust?
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.
GP, HV or PN 54% 92%
NHS 42% 86%
No
Pharmacist 19% 66% difference
by age of
child
Government 18% 58%
Family/friends 14% 49%
Strongly agree
Slightly agree
Media 4% 21%
Base: 2010 - parents of 0-4s (1730)

24. "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).