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Physical and mental health for young children
Physical and mental health for young children

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3.3 What can be done to reduce the spread of communicable diseases?

In Session 4 you explored some of the ways that the spread of communicable diseases can be prevented. The main ways of doing so include effective handwashing and through immunisation. All children in the UK are eligible for free immunisations against several communicable diseases, however, many parents are hesitant about having their child immunised: so-called ‘vaccine hesitancy’. In the next activity, you’re asked to list as many reasons as you can as to why some parents may decide not to take their child for immunisation.

A photograph of a child being vaccinated
Figure 2 The importance of immunisation

Activity 2 Why do some parents not take their child to be immunised?

Timing: 10 minutes

Make a list of as many reasons as you can think of that help to explain why some parents may decide not to have their child immunised.

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Public Health England commissioned a national survey of parental attitudes to the national childhood immunisation programme. The survey reported in 2018 that confidence is high for the majority of parents. However, there are several reasons why parents may not take their children for immunisations, they include:

  • cultural and religious reasons
  • hard-to reach parents
  • parents who work may have difficulty getting time to attend clinics
  • parental concerns about ‘overloading’ their child’s immune system
  • concerns about the safety of immunisations
  • lack of knowledge.

In addition to these reasons, some parents may not like taking seeing their child in discomfort following an injection. You may have identified other reasons. Table 1 explains more about the above reasons.

Table 1 Reasons why parents choose not to immunise their child
Cultural and religious resistance to immunisations

Despite the evidence of the effectiveness of immunisations in reducing the number of cases of infectious diseases, there are groups of people who believe that they should not be given to their children. In July 2019, Public Health England reported concerns about the possible low uptake by some Muslim parents of a new influenza vaccination for their children because it has been reported to contain gelatine derived from pigs which of course is not halal.

Concerns about the suitability of vaccinations for some religious groups is a global issue, for example the United States has a policy that makes it mandatory for children to have received immunisations before they start school. However, there has been a rise in the number of cases of measles in some parts of Brooklyn, a suburb of New York City. The extent of the number of cases has resulted in the mayor of the city declaring a public health emergency and has ordered all residents to be vaccinated. The outbreak started in the Orthodox Jewish community and has been ‘fuelled by a small group of anti-vaxxers’ (Kendall-Raynor, 2019, p. 8). Anti-vaxxers are people who are against vaccination.

A research study conducted in the Netherlands found that the orthodox Protestant religious leaders interviewed believed that giving immunisations ‘interfered with divine providence’ (Rijs, Hautvast, Kerrar, Ven der Velden and Hulscher, 2013). This is interpreted as meaning that giving immunisations is challenging the will of God.

Reaching parents

Some parents are regarded as being ‘hard to reach’, meaning that they are often unable or reluctant to access health services for their children. Again, this is a global issue. For example, in Australia the uptake of immunisations by parents for their children is a concern (Pelag, 2018). Immunisation is a free service in Australia, and despite there being reports of children dying as a consequence of preventable infection, it was found that half the number of children who were eligible to have immunisations were receiving them. Reasons cited for low uptake of immunisations included a lack of access to services. In a country that is as large and areas that are geographically difficult to access, this is a major challenge. In some parts of the UK, many parents find it difficult to access services. For instance, as discussed in Session 3, living in poverty, especially in a remote rural area, can be a factor that mean it can be difficult to attend an immunisation session.

Parental concerns about immunisation

Parental concerns about immunisation included fears about ‘overloading’ their child’s immune system. However, immunisations have been available for many years and are very effective in helping to prevent, or at least reduce the severity of an infectious disease. Children may have a short-term response to receiving immunisations, which is simply their immune systems working effectively.

Concerns about the safety of immunisations came to the fore in the 1990s when Andrew Wakefield had a paper published in the prestigious medical journal, The Lancet. The paper raised concerns about a link with autism and the measles, mumps and rubella (MMR) immunisation. The study was based on a small number of participants, 12 in total, and the findings were inconclusive. The findings were discredited, and the paper was subsequently withdrawn. Despite the findings being discredited, the publicity led to a drop in parental confidence in the MMR immunisation and many chose not to have their children immunised.

The legacy of the MMR scandal is still evident today and continues to influence parents’ decisions about whether to have their child immunised.

Lack of knowledge among adults, especially parents, is a significant factor in whether they choose to have their children immunised. So, what can be done to help parents to understand the reasons why immunisation is important in preventing their child contracting a communicable disease that is largely preventable?