VI. WHY CHILDREN WERE NOT IMMUNISED

If the child selected from the register had not been immunised the mother was asked the reason for this. The purpose of the question was to discover to what extent mothers had a positive resistance to having their children immunised, and what these resistances were, and to what extent failure to have children immunised was simply the result of “not bothering”.

The possible answers to the question, or rather the answers likely to occur most frequently, had been discovered by the earlier inquiry made in 1942. However in that inquiry if mothers gave more than one reason all reasons were counted and as the categories overlapped to some extent this was not thought to be a very satisfactory method.

In the present inquiry interviewers were told to record only one reason, that one being the more specific. For instance if a mother said, “I haven’t bothered because he is not old enough yet” that answer would count as “child not old enough yet”, and not as “have not bothered”. Similarly if the answer was “I don’t believe in it. He would be frightened”. It was counted as “child would be frightened”, and not as “don’t believe in it, not worth-while”.

The reason given most frequently was that the child was not old enough. 75% of the children about whom this answer was given had not in fact reached their first birthday. The ages of children were not recorded in months but it is likely that about three quarters of these children would be less than 10 months old, and therefore would be too young. The remaining 25% were all under seven and more than half of them were under three. Altogether 28% of the mothers of immunised children gave this answer and it may be said, that about 8% or 9% were mistaken in thinking their children too young and about 20% had children who really were too young. These would form about 3% and 6% respectively of all mothers interviewed. The proportion of all mothers thinking erroneously that young children should not be immunised is thus very small, only about 3%. (It was shown in section III that 56% of mothers know that the best age for immunisation was about one).

23% of those whose children had not been immunised admitted frankly that they had not bothered or had not had time.

A further 15% either rationalised this into “I don’t believe in it” or “It’s not worthwhile” or really held this opinion. These form 9% of the whole sample. It will be remembered that in answer to the question “Do you know how diphtheria can be prevented?” 3% said they did not believe diphtheria could be prevented. It is not possible to say how many of those who did not think immunisation was worthwhile were sceptical as to its results, and how many simply thought it was unnecessary for healthy children to be immunised, but in is clear that the whole group forms only quite a small proportion of all mothers.

Other more definite answers such as “My husband objects” or “The child would be frightened” were given by relatively small proportions.

Only 4% of the mothers asked the question, representing about 1% of all mothers in the sample, said they had not heard about immunisation at all before it was mentioned by the interviewer.

Grouping together those who answered “Don’t believe in it”, “Husband objects” and “Would hurt, or frighten child” shows that about 9% of all mothers have a positive resistance to immunisation. If those saying they had not bothered or had not time are grouped with those who had children of an age to be immunised, but who thought they were too young, and those who had never heard of immunisation, it is found that about 12% of mothers have not had their children immunised owing to ignorance or apathy. The remainder gave other sorts of reasons.

There are no noteworthy differences in the proportions of mothers living in large and small towns and in rural areas giving different replies.

Analysis by region showed that a relatively high proportion of mothers of unimmunised children said that immunisation was not worthwhile or expressed disapproval of it. n the North of England, 21% as compared .with 12% on all other regions taken together. If the numbers giving this answer are expressed as percentages of all the women interviewed the difference is even more obvious since more children in the North than in other regions had not been, immunised. The percentages are 8% for the North, and 3% for all other regions together.

A significantly higher proportion in the South and East (8% of those with unimmunised children) than in London (1%) and the Midlands (2%) said they had not heard about immunisation before. The proportions of mothers noticing various sorts of publicity, with the exception of statements in newspapers and magazines, were on the low side, though not very low, in the South and East.

The numbers to whom this question applied in the highest economic group, and in the higher education group, are small, and separate analysis are not given. It may be said however that the proportions saying they had not bothered or had not had time to have their children immunised were some what greater in the lower than in the higher groups. Disapproval on the part of the husband were of more importance in the lower education group than in the higher group.