Interview 22

Brief Outline: His partner is a young teacher who indicates she has no problem in approaching her GP or other doctors in the surgery to discuss issues regarding contraception or sexual health. She has only used oral contraceptives.

Background: A couple - An Australian student who says that he learned a lot about sexual health from reading his older sister's magazines. He cannot understand how guys with no sisters cope or where they get their information from.

Her son had no reaction to the MMR vaccine.

Actually I gave the MMR myself. Took a dose from work and you know while I was here one evening I thought it was the easiest thing to do. And again he was absolutely fine after that. He had no problems at all either with the, you know, and sometimes MMR can be associated with vaccine reactions two or three weeks later and he didn't have anything at all really. Certainly not that I was aware of or worried about. He was absolutely fine after the vaccinations he's had.

Talk to the community paediatrician if you have concerns.

That's what we're there for, you know, in terms of the community paediatrics that we do immunisation is a major part of what we deal with. And  we are certainly there and available to answer any questions. We have regular child health clinics for parents. Most of them, certainly where I work there are walk-in clinics, you don't even need an appointment. Yeah you can just come in and, and talk about it. And actually where I work if parents do have specific concerns or they want to have more time to address concerns in detail we have other clinics that we run where I can refer the parents to have that opportunity to talk about it with, with other paediatric staff. And actually have a set appointment to be able to have the time to address that. So we have that available as well. If parents want that or if there are specific things they want to talk about I'm certainly quite happy to do that. It may involve, you know, two or three weeks waiting to get the appointment. But it's not a huge amount of time. It's not going to make a significant difference. And that will give them the opportunity to talk about whatever it is in more detail. And I've certainly done that a few times. When I just haven't been able to sort it out in the particular setting or in the particular time scale. I'm certainly able to do that and, and it's absolutely fine. It happens quite a lot.

Talking about their concerns to a health professional can sometimes help parents to make their mind up about immunisations.

So, the other concern is, is at the moment I've found a lot of parents are quite wary about giving the six-in-one or the five-in-one and then the meningitis C with it. And I felt often it just takes quite a lot of reassurance. Some of them don't necessarily seem to be aware that we actually are giving the same vaccines that they were before. It's just in a different form. And it's 'oh isn't that a lot to be giving at the same time?' It's like well we have been doing that for years and just explaining that. Often it just needs a few minutes of time and, and just addressing their concerns and making sure they've got the correct information which often they don't. And sometimes that's all it needs, not always but often if they do have a chat with myself or the health visitor or with the immunisations nurse you know often it will correct their misconceptions and there are quite a lot out there unfortunately. I've found that. There are a lot of people who just, particularly from the media, have, have just picked up what they want to hear and ignored the rest and that's then [pause] made them choose what may not necessarily be the right thing.
 

Believed the risk of the diseases and complications of the disease to be a greater risk than the...

Most of the vaccines don't have significant side effects. Yes some of them have associated with them a very, very, very, very small risk. But in terms of, of how I feel about it, the risk of the actual diseases and complications of the diseases are far higher than, than the side effects associated with some of these vaccines particularly now that we've gone to a killed version of polio. Again there was a very, very, very small risk associated with live polio, which has now been eliminated for example. 

So for me side effects weren't really an issue that I had a problem with, not compared with the actual illnesses that we are protecting against. 

From my point of view I consider both the primary vaccines and the MMR vaccines to be safe. And the illnesses that are being vaccinated against are serious. They can have significant long-term implications if a child does catch one of these diseases and the risk of the vaccines and side effects of the vaccines is far, far less than the risk of the illnesses themselves. So from my point of view I would say go ahead and vaccinate and if you've got any questions make sure you talk to the right people to get the correct information before making your decision really. That's how I feel about it and I've been happy to give my son all his vaccines and he's been absolutely fine.

In her work as a community paediatrician, she has seen children with some of these diseases.

These conditions, these illnesses certainly are less common than they were but like I said I've certainly seen them and this is in England. It's still happening and yes things like polio are incredibly rare now and hopefully will be eliminated relatively soon but we are still seeing it and the advice is still that they need protecting against. Things like meningitis C we are definitely still seeing and they are serious and they've got a 10% mortality. You know, it's, oh a, I've certainly seen children with meningitis and they've been incredibly unwell. That's certainly not a disease that is disappearing, for example. Hib, haven't seen much of but if we stop vaccinating we'll probably start to see more. It's certainly less common than it was 20 years ago but that's proof, directly related to the fact that the Hib vaccine was introduced then in the 80s. We've seen far, far less since then but that certainly doesn't, doesn't mean that it's eliminated and that we should stop vaccinating because of that.

I understand a lot of parents feel, okay let everyone else immunise I don't want to. That's often a, you know, if most of the population are immunised fine I'll be the one who doesn't. But if everyone has that attitude then you're not going to get uptake levels high enough to actually give herd immunity. And okay if a few don't it's not going to make a major impact but enough people, if enough people decide not to for that reason that will leave it to everyone else then you're still going to get these diseases occurring and your not going to be able to keep the levels down. And for example you're then putting very young babies at risk who haven't got to the stage where they should be immunised yet.