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Introduction: The aim of this study was to investigate why parents in one county of Denmark leave vaccination against measles, mumps and rubella (MMR) undone, with special reference to evaluating the possibilities of increasing the acceptance of the MMR vaccination program., Materials and Methods: Data were collected through semi-structured, tape-recorded telephone interviews. The interviewees were 17 strategically chosen parents of children 15 months and 12 years old who had not received the MMR vaccination in 2002. The method of analysis was Systematic Text Condensation., Results: The parents had consulted many sources in their search for information about MMR vaccination. Many referred to their own or others' good experiences with going through the natural illnesses and bad experiences with vaccination. It is a common view that naturally occurring illnesses strengthen the immunity more effectively than vaccination does, and this approach is preferred by some of the parents. The risk of vaccination is viewed as greater than that of going through the natural illnesses. This, however, is not in accordance with scientific knowledge. There was no evidence that leaving vaccination undone was due to the parents' lack of knowledge, forgetfulness or lack of interest in MMR vaccination, and it was rare that only one reason was mentioned., Conclusion: The results of the study indicate that doctors can profit by preparing a dialogue with parents who are in doubt about MMR vaccination. Especially it seems that a profound knowledge of the scientific evidence of virus-caused diseases, of their risks and of immunology is necessary to balance parents' most essential misconceptions and their reasons for not choosing vaccination.

A 12-year-old girl got abdominal pain three weeks after having received the second vaccination against MMR. MRCP showed dilatation of ductus choledochus and edema of caput pancreaticus. No stone was to be seen and the P-calcium level was normal. Hepatitis A virus, Ebstein-Barr virus, cytomegalovirus, enterovirus, serum col hemaggutinins, Yersinia and cystic fibrosis were all negative. Pancreatitis is seen with endemic parotitis and we suggest that MMR vaccination may have a causal connection with the above case.

Introduction: The aim was to determine how much knowledge parents have of MMR diseases and the side effects of the vaccine, and what influence this has on acceptance of the vaccination programme., Materials and Methods: Sampling three districts of Roskilde County was done by the distribution of 1867 questionnaires to the parents of children aged 0-15 years in 22 institutions and schools (1 January to 28 February 2000)., Results: Of the 878 (47%) replies, 825 (94%) had followed the vaccination programme. There was no difference between those who had followed the programme and those who had not with respect to reports of complications to the diseases, but the latter group reported more complications to the vaccine. In the vaccinated group, there were significantly more who stated that the doctor's opinion of the vaccine was positive, and acceptance of the remaining vaccination programme was also greater in this group. More children in the non-vaccinated group were involved in the decision about vaccination., Discussion: Though knowledge of the diseases does not seem to influence the decision about vaccination, the responses raise the question of how information is to reach the general public. An open debate is needed on vaccination complications, as it is these or uncertainty about them that seem to influence the parents' choice. For 70% of parents, the doctor is their source of information, and it is therefore important for acceptance of the MMR vaccine that doctors have a positive view and are able to communicate this view to the parents.

Introduction: It has been suggested that the measles-mumps-rubella (MMR) vaccination causes autism., Material and Methods: We conducted a retrospective cohort study of all children born in Denmark from January 1991 through December 1998. The cohort was established based on data from the Danish Civil Registration System. A unique person identifiable number given to all subjects enabled linkage with other national registries. MMR vaccination status was obtained from the Danish National Board of Health. Information on the children's autism status was obtained from the Danish Psychiatric Central Register which contains information on all diagnoses received from psychiatric hospitals, psychiatric wards, and outpatient clinics in Denmark. We obtained information on potential confounders from the Danish Medical Birth Registry, the National Hospital Registry, and Statistics Denmark., Results: In the cohort of 537,303 children (2,129,864 person-years), 440,655 children had been MMR vaccinated. We identified 316 children with a diagnosis of autistic disorder and 442 with a diagnosis of other spectrum disorders. After adjusting for potential confounders, the risk for autistic disorder and other spectrum disorders was not increased in vaccinated compared with unvaccinated children (relative risk 0.92; 95 percent confidence interval, 0.68 to 1.24 and relative risk 0.83; 95 percent confidence interval, 0.65 to 1.07). There was no association between age at vaccination, time since vaccination or calendar period at time of vaccination and development of autistic disorder., Discussion: This study provides strong evidence against the hypothesis that MMR vaccination causes autism.