Low immunisation uptake: is the process the problem?

OBJECTIVE To examine mothers' satisfaction with the process of immunisation and its possible contribution to suboptimal immunisation uptake. DESIGN In depth interviews with mothers. SETTING Two Community Care Areas, Dublin city, Ireland. PARTICIPANTS In depth interviews of 23 mothers of children 1-2 years old, recruited purposively from a birth cohort born in 1994. MAIN RESULTS Mothers preferred general practice to Health Centre immunisation (11:5) for predominantly emotional compared with practical reasons (4:1). Health Centre immunisation was seen, at times, as unacceptably rough and inhuman. Many mothers experienced severe emotional distress at the prospect of inflicting the pain of immunisation on their babies. The non-empathic stance of some immunising doctors was unacceptable to mothers. They valued attempts by health professionals to acknowledge the pain of immunisation and to engage with their baby. Adverse experiences contributed to deferral of future visits and to defaulting behaviour. CONCLUSIONS Low empathy mass immunisation in clinic type settings may be unacceptable to mothers in the 1990s, and may in part explain suboptimal uptake in health care systems that use such clinics.