Objectives:

• To increase awareness of the seriousness of measles, mumps and rubella as childhood diseases.
• To provide information and increase knowledge of how the MMR immunisation protects children from these childhood diseases.
• To increase knowledge of the ages at which the MMR immunisation and the booster immunisation is given.
• To help answer parents' questions about the MMR immunisation.
• To motivate parents to get their children immunised.
• To answer parents' queries raised by media speculation about links between the combined MMR vaccine and autism and Crohn's disease.

Background:
Since the introduction of the MMR vaccine in Northern Ireland in 1988, the number of children catching these serious diseases has fallen. However, in 2001 there was widespread media coverage about the safety of the combined MMR vaccine and a link was suggested between the vaccine and Crohn's disease and autism. In response to this the HPA commissioned qualitative research among parents of young children.

The aim of the research was to examine attitudes towards MMR, the impact of the adverse media coverage and parents' willingness to have their children vaccinated. The research found that, in general, parents appreciated the benefits of immunisation and considered the advantages to outweigh any disadvantages. All the parents interviewed were aware of the MMR vaccine and the media reports. While the reports had caused parents some concern, the research concluded that there did not appear to be a major danger of widespread refusal to have children immunised with the MMR vaccine.

As part of the research the existing information leaflet for parents along with a new resource, The MMR story, Mythbuster, were tested. The latter was produced in Wales and is used by health professionals when discussing the MMR vaccine with parents. Both resources were generally well received by the parents interviewed but some suggestions were made as to how content, look and format could be improved.

Following this research the HPA was commissioned to revise and update the existing materials for parents and health professionals as part of a public information programme on MMR. The programme aimed to emphasise the importance of immunisation and reassure parents of the safety of the MMR vaccine.

The campaign:
The campaign involved revising information for parents and health professionals to take account of findings in the qualitative research.

The revised version of the booklet The facts about MMR vaccine was produced in A6 format. This size was chosen so that the booklet could be easily mailed by the Child Health System to parents as their child's vaccination date approached or be inserted into the child's personal health record to provide information at the appropriate time. The booklet was produced in audiotape version for parents who are blind or visually impaired and for members of the Travelling community. It was also translated into a number of minority ethnic languages.

An information pack for health professionals was created containing five elements:

• the public leaflet The facts about MMR vaccine
• The MMR vaccine. Information for health professionals based on revised versions of the existing factsheets and including up-to-date research information supporting the use of MMR.
• The MMR vaccine. Detailed answers to parents' questions.
• The MMR story, Mythbuster, a resource produced by North Wales Health Authority.
• a supporting statement endorsed by a number of local health professionals.

These packs were mailed to GPs, health visitors and other health professionals. The revised materials were published in March 2001 and launched in April 2001. The public leaflet was reprinted in January 2003.