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‘Just that Little Bit of Doubt’: Scottish Parents', Teenage Girls' and Health Professionals' Views of the MMR, H1N1 and HPV Vaccines

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Parental decision making about childhood vaccinations is complex and the vaccination schedule ever-changing. Vaccination may be controversial even in countries with historically high vaccination rates such as Scotland. Health behaviour models have aided understanding of individual vaccine intentions for specific vaccines. These are limited in explaining actual behaviours and are divorced from the impact of socio-cultural contexts on vaccination decision making.


To explore vaccination views in Scotland amongst parents, teenage girls and health professionals across three controversial vaccines: the Measles, Mumps, Rubella (MMR), the Human Papilloma virus (HPV) and the Influenza A (H1N1) vaccine.


We used qualitative interviews and focus group discussions in a purposive sample of health professionals (n = 51), parents (n = 15) and teenage girls aged 12–15 years (n = 8) about their views of these vaccines. Discussions were analysed using thematic analysis.


Two main themes are highlighted: ‘vaccine risks revisited’ in which we explored how the MMR legacy resurfaced and how worries about vaccine safety permeated the data. ‘Vaccine responsibilities’ indicated tensions regarding roles and responsibilities for vaccines. An overarching notion of ‘just that little bit of doubt’ referred to lingering doubts and uncertainties interwoven across the vaccines.


Public health authorities should remain alert towards pervasive vaccine concerns. It is important for authorities to clarify vaccine roles and responsibilities in the face of new and existing vaccines and to acknowledge public concerns regarding vaccine safety.

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  1. There are 14 national health boards in Scotland, each with its own responsibility for provision of health services.

  2. In Scotland, a range of health professionals is involved in the delivery of vaccinations including general practitioners and community nurses. Practice nurses are attached to general practitioner surgeries. Health visitors primarily work with babies and toddlers, whereas school nurses work with school-aged children.

  3. Coding identifiers appear as follows: participant number and data collection method.

  4. At the time of the MMR controversy, some parents paid privately to have separate, single doses of the MMR vaccine in the belief that this would minimise potential risks.

  5. Reference to media reporting of a death in Conventry, UK, which was later reported to be unrelated to the HPV vaccine.


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This study was funded in part through the NHS Lothian Health Service Research Programme and in part through funding from Edinburgh Napier University. Thanks to Patricia McIntosh for facilitating this work and also to the clinical leads and parents, young people and health professionals who participated in this study. We also thank the study steering group for guidance during the conduct of this study.

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Correspondence to Carol Gray Brunton.

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Kennedy, C., Gray Brunton, C. & Hogg, R. ‘Just that Little Bit of Doubt’: Scottish Parents', Teenage Girls' and Health Professionals' Views of the MMR, H1N1 and HPV Vaccines. Int.J. Behav. Med. 21, 3–10 (2014).

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