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Journal article

‘Get your own house in order’: qualitative dialogue groups with non-vaccinating parents on how measles outbreaks in their community should be managed

Vaccine hesitancy Child health Infectious diseases Australia

Objective: Communities with high levels of vaccine rejection present unique challenges to vaccine-preventable disease outbreak management. This paper sought perspectives of non-vaccinating parents to inform public health responses in such communities.

Methods: Nineteen purposively sampled non-vaccinating Australian parents participated in one of seven online dialogue groups. We asked what they thought parents, school principals and public health professionals should do in a hypothetical school measles outbreak and used a framework approach to data analysis.

Results: Parents' views were grounded in strong beliefs in parental responsibility and the belief that vaccines are not effective, thus unvaccinated children do not therefore pose a threat. They then reasoned that the forced exclusion of unvaccinated children from school in a measles outbreak was disproportionate to the risk they pose, and their child's right to education should not be overridden. Non-vaccinating parents judged that all parents should keep sick children at home regardless of disease or vaccination status; that school principals should communicate directly with parents and avoid using social media; that public health professionals should provide information to parents so they can decide for themselves about excluding their children from school; that public health responses should avoid accidental identification of unvaccinated children and that mainstream media should be avoided as a communication tool.

Conclusion: Non-vaccinating parents do not always agree with current Australian approaches to measles outbreak management. Their perspectives can inform approaches to outbreak responses in communities with high levels of vaccine rejection.

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