Parental decision-making in uptake of the MMR vaccination: a systematic review of qualitative literature

J Public Health (Oxf). 2015 Dec;37(4):678-87. doi: 10.1093/pubmed/fdu075. Epub 2014 Oct 8.


Background: Controversy has surrounded MMR vaccination in the aftermath of Wakefield's 1998 paper suggesting links between MMR and the development of pervasive developmental disorder in children. The paper sparked off media debate and contributed to a lack of parental trust in health-care providers and reduction in MMR uptake. This review aims to identify and evaluate research on the subject, with a view to present the reasons behind, and influences on parental decision-making in relation to MMR.

Methods: Systematic search strategy identified 14 relevant papers on which thematic analysis was performed.

Results: Themes identified were categorized as follows: perceptions of risk; roles and responsibility; experience and knowledge. There were limited changes in parental decision-making factors over the time period despite an increase in uptake. Many studies fail to differentiate between accepters and rejecters, making it difficult to draw out clear conclusions.

Conclusion: Policymakers need to adapt information provided to address these concerns. Future research should focus more on distinguishing between accepters and rejecters to determine which factors can alter outcome.

Keywords: MMR; decision making; parents; qualitative systematic review.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Decision Making*
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Measles-Mumps-Rubella Vaccine
  • Parents / psychology*
  • Patient Acceptance of Health Care


  • Measles-Mumps-Rubella Vaccine