Qualitative analysis of determinants of measles, mumps, rubella vaccine uptake in European parents

Background Parental concerns about measles, mumps and rubella (MMR) vaccination negatively influence decision to vaccinate their children, this leading to the recently reported vaccine coverage drop in Europe. The ESCULAPIO project, funded by the Italian National Centre for Disease Prevention and Control of the Ministry of Health (CCM), is investigating the main factors underlying decisions on vaccinations, in order to implement targeted campaigns and plan effective strategies. Methods A systematic literature review was carried out on studies describing the determinants underlying MMR vaccination uptake in European parents. Results A total of 45 studies were included in the analysis. The most common factors related with MMR vaccine uptake were knowledge, beliefs, perceptions on vaccines and diseases, reported in 44,4% of the articles. Parents showed doubts on vaccine efficacy, safety, side effects, while in other studies positive beliefs and perceptions were reported. Attitudes/ behaviours were often determinants of the uptake as well as demographic factors (40%). While higher no. of children in the household, lower income, temporary or lacking employment, and non-regular marital status were generally a barrier for vaccination, education level and house tenure were contradictory. Information source/advice and influence or trust of other people, institutions, media were often reported (31,1% and 17,8% respectively), but a clear direction was not showed. Conclusions These preliminary findings showed that communication strategies should provide parents with clear messages on vaccines and preventable infectious diseases, in order to build right knowledge and create correct beliefs and behaviours. Communication should be addressed mainly to more disadvantaged, larger and non-regular families. A quantitative analysis is been currently carrying out and will provide more information on the direction of the effect of the different factors