Factors influencing the uptake of childhood immunisation in rural areas.

BACKGROUND: Childhood vaccination has been vigorously debated in recent years. Professional and parental confidence in the measles- mumps and rubella (MMR) vaccine in particular has been shaken- as reflected by its decreased uptake. AIM: To investigate the influence of practice type and the method of vaccination call/recall on childhood immunisation coverage. DESIGN: Analysis of childhood immunisation uptake rates. SETTING: General practices in the Highland NHS Health Board area in Scotland. METHOD: Data on the immunisation uptake of individual practices in the region were obtained from the Information and Statistics Division of NHS Scotland. RESULTS: Uptake of all vaccines in children reaching the age of 2 years was lower in practices using their own call/recall system than those engaged with the national system. Inducement practices achieved lower uptake than non-inducement practices for every immunisation studied- with the differences ranging from 4.7% to 7.8%. Compared with group practices- uptake of all