{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,25]],"date-time":"2025-12-25T19:00:41Z","timestamp":1766689241721,"version":"3.48.0"},"reference-count":26,"publisher":"BMJ","issue":"6995","license":[{"start":{"date-parts":[[1995,6,24]],"date-time":"1995-06-24T00:00:00Z","timestamp":803952000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ"],"accepted":{"date-parts":[[1995,4,13]]},"published-print":{"date-parts":[[1995,6,24]]},"abstract":"<jats:p>Objective \u2014To investigate the reasons for poor uptake of immunisation (non-immunisation) and the possible side effects of measles, mumps, and rubella vaccine in a catch up immunisation campaign during a community outbreak of measles.<\/jats:p>\n                  <jats:p>Design \u2014Descriptive study of reasons for non-immunisation and retrospective cohort study of side effects of the vaccine.<\/jats:p>\n                  <jats:p>Setting \u2014Secondary schools in South Glamorgan.<\/jats:p>\n                  <jats:p>Subjects \u2014Random cluster sample of the parents of 500 children targeted but not immunised and a randomised sample of 2866 of the children targeted.<\/jats:p>\n                  <jats:p>Main outcome measures \u2014Reasons for non-immunisation; symptoms among immunised and non-immunised children.<\/jats:p>\n                  <jats:p>Results \u2014Immunisation coverage of the campaign was only 43.4% (7633\/17,595). The practicalproblems experienced included non-return of consent forms (6698\/17,595), refusal of immunisation (2061\/10,897 forms returned), and absence from school on day of immunisation (1203\/8836 children with consent for immunisation). The most common reasons cited for non-immunisation were previous measles infection (145\/232),previous immunisation against measles (78\/232), and concern about side effects (55\/232). Symptoms were equally common among immunised and non-immunised subjects. However, significantly more immunised boys than non-immunised boys reported fever (relative risk 2.31 (95% confidence interval 1.36 to 3.93)), rash (2.00 (1.10 to 3.64), joint symptoms (1.58; 1.05 to 2.38), and headache (1.31 (1.04 to 1.65)).<\/jats:p>\n                  <jats:p>Conclusions \u2014Many of the objections raised by parents could be overcome by emphasising that primary immunisation does not necessarily confer immunity and that diagnosis of measles is unreliable. Measles, mumps, and rubella vaccine is safe in children aged 11-15.<\/jats:p>\n                  <jats:sec>\n                    <jats:title>Key messages<\/jats:title>\n                    <jats:list list-type=\"bullet\">\n                      <jats:list-item>\n                        <jats:p>Parents frequently object to immunisations for their children on various grounds, including previous immunity and concern about adverse effects<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Previous immunisation or clinical measles was found to be a frequent reason for non-immunisation in a mass campaign<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Advice to parents should emphasise that primary immunisation against measles, mumps, and rubella may fail to confer immunity and that a clinical diagnosis of measles is unreliable<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>The incidence of adverse effects of measles, mumps, and rubella vaccine in the 11-15 year age group in the United Kingdom is low<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:sec>","DOI":"10.1136\/bmj.310.6995.1629","type":"journal-article","created":{"date-parts":[[2011,10,27]],"date-time":"2011-10-27T19:35:42Z","timestamp":1319744142000},"page":"1629-1639","source":"Crossref","is-referenced-by-count":35,"title":["Reasons for non-uptake of measles, mumps, and rubella catch up immunisation in a measles epidemic and side effects of the vaccine"],"prefix":"10.1136","volume":"310","author":[{"given":"Richard J","family":"Roberts","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Quentin D","family":"Sandifer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Merion R","family":"Evans","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Z","family":"Nolan-Farrell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul M","family":"Davis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1995,6,24]]},"reference":[{"key":"2025122510560687000_310.6995.1629.1","unstructured":"Office of Population Censuses and Surveys . Infectious diseases: quarterly digest. London: HMSO, 1994. (Series MB2)"},{"key":"2025122510560687000_310.6995.1629.2","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1136\/bmj.297.6651.770","article-title":"Surveillance of antibody to measles, mumps and rubella by age.","volume":"297","author":"Morgan-Capner","year":"1988","journal-title":"BMJ"},{"key":"2025122510560687000_310.6995.1629.3","first-page":"147","article-title":"National measles and rubella campaign.","volume":"4","year":"1994","journal-title":"Commun Dis Rep CDR Wkly"},{"key":"2025122510560687000_310.6995.1629.4","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1136\/bmj.308.6935.1015","article-title":"Salivary diagnosis of measles: a study of notified cases in the United Kingdom 1991\u20133.","volume":"308","author":"Brown","year":"1994","journal-title":"BMJ"},{"key":"2025122510560687000_310.6995.1629.5","first-page":"R70","article-title":"Measles in secondary school children: implications for vaccination policy.","volume":"4","author":"Calvert","year":"1994","journal-title":"Commun Dis Rep CDR Rev"},{"key":"2025122510560687000_310.6995.1629.6","first-page":"R73","article-title":"An outbreak of measles in Trafford.","volume":"4","author":"Richardson","year":"1994","journal-title":"Commun Dis Rep CDR Rev"},{"key":"2025122510560687000_310.6995.1629.7","unstructured":"Lyons RA Jones HI Salmon RL . Successful control of a school based measles outbreak by immunisation. Epidemiol Infect (in press)."},{"key":"2025122510560687000_310.6995.1629.8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198703263161303"},{"key":"2025122510560687000_310.6995.1629.9","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1093\/oxfordjournals.aje.a115106","article-title":"An explosive point-source measles outbreak in a highly vaccinated population.","volume":"129","author":"Chen","year":"1989","journal-title":"Am J Epidemiol"},{"key":"2025122510560687000_310.6995.1629.10","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1056\/NEJM198901123200202","article-title":"Patterns of transmission in measles outbreaks in the United States, 1985\u201386.","volume":"320","author":"Markowitz","year":"1989","journal-title":"N Engl J Med"},{"key":"2025122510560687000_310.6995.1629.11","doi-asserted-by":"crossref","first-page":"360","DOI":"10.2105\/AJPH.81.3.360","article-title":"A measles outbreak at a college with a prematriculation immunisation requirement.","volume":"81","author":"Hersh","year":"1991","journal-title":"Am J Public Health"},{"key":"2025122510560687000_310.6995.1629.12","unstructured":"Dean AG Dean JA Burton AH Dicker RC . Epi Info, version 5: a word processing, database, and statistics program for epidemiology on microcomputers. Stone Mountain, GA: USD, 1990."},{"key":"2025122510560687000_310.6995.1629.13","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1111\/j.1365-2648.1991.tb01616.x","article-title":"Failure to immunise children under 5 years: a literature review.","volume":"16","author":"Lochhead","year":"1991","journal-title":"J Adv Nurs"},{"key":"2025122510560687000_310.6995.1629.14","first-page":"28","article-title":"Why children are not immunised.","volume":"21","author":"Hull","year":"1987","journal-title":"J R Coll Physicians Lond"},{"key":"2025122510560687000_310.6995.1629.15","doi-asserted-by":"publisher","DOI":"10.1016\/S0033-3506(05)80476-7"},{"key":"2025122510560687000_310.6995.1629.16","doi-asserted-by":"crossref","first-page":"1687","DOI":"10.1136\/bmj.298.6689.1687","article-title":"Parents' beliefs about vaccination: the continuing propagation of false contraindications.","volume":"298","author":"Klein","year":"1989","journal-title":"BMJ"},{"key":"2025122510560687000_310.6995.1629.17","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1136\/bmj.307.6905.681-b","article-title":"Improving uptake of immunisation.","volume":"307","author":"Barrett","year":"1993","journal-title":"BMJ"},{"key":"2025122510560687000_310.6995.1629.18","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1136\/bmj.307.6897.168","article-title":"Factors affecting uptake of measles, mumps, and rubella immunisation.","volume":"307","author":"Li","year":"1993","journal-title":"BMJ"},{"key":"2025122510560687000_310.6995.1629.19","doi-asserted-by":"publisher","DOI":"10.1016\/0264-410X(91)90053-9"},{"key":"2025122510560687000_310.6995.1629.20","first-page":"549","article-title":"Measles vaccination reactions among college students - North Carolina, Massachusetts.","volume":"29","year":"1980","journal-title":"MMWR"},{"key":"2025122510560687000_310.6995.1629.21","doi-asserted-by":"publisher","DOI":"10.1016\/0264-410X(94)90338-7"},{"key":"2025122510560687000_310.6995.1629.22","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1016\/S0140-6736(86)91044-5","article-title":"Frequency of true adverse reactions to measles-mumps-rubella vaccine.","volume":"i","author":"Peltola","year":"1986","journal-title":"Lancet"},{"key":"2025122510560687000_310.6995.1629.23","first-page":"69","article-title":"Surveillance of symptoms following MMR vaccine in children.","volume":"223","author":"Miller","year":"1989","journal-title":"Practitioner"},{"key":"2025122510560687000_310.6995.1629.24","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1002\/art.1780200216","article-title":"Chronic arthropathy associated with rubella vaccination.","volume":"20","author":"Spruance","year":"1977","journal-title":"Arthritis Rheum"},{"key":"2025122510560687000_310.6995.1629.25","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1136\/bmj.304.6834.1075","article-title":"Joint and limb symptoms in children after immunisation with measles, mumps, and rubella vaccine.","volume":"304","author":"Benjamin","year":"1992","journal-title":"BMJ"},{"key":"2025122510560687000_310.6995.1629.26","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1136\/bmj.308.6935.1015","article-title":"Salivary diagnosis of measles: a study of notified cases in the United Kingdom, 1991\u20133.","volume":"308","author":"Brown","year":"1994","journal-title":"BMJ"}],"container-title":["BMJ"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bmj.310.6995.1629","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmj.310.6995.1629","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,25]],"date-time":"2025-12-25T18:56:13Z","timestamp":1766688973000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.bmj.com\/lookup\/doi\/10.1136\/bmj.310.6995.1629"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1995,6,24]]},"references-count":26,"journal-issue":{"issue":"6995","published-online":{"date-parts":[[1995,6,24]]},"published-print":{"date-parts":[[1995,6,24]]}},"alternative-id":["10.1136\/bmj.310.6995.1629"],"URL":"https:\/\/doi.org\/10.1136\/bmj.310.6995.1629","relation":{},"ISSN":["0959-8138","1468-5833"],"issn-type":[{"type":"print","value":"0959-8138"},{"type":"electronic","value":"1468-5833"}],"subject":[],"published":{"date-parts":[[1995,6,24]]}}}