'As every good mother should'. Childhood immunization in New Zealand: a qualitative study

Immunization coverage is a cause for concern in both developed and developing countries. In New Zealand immunization uptake rates have been estimated at less than 60% for children under the age of 2 years old. A qualitative exploration of knowledge, experiences and concerns appeared necessary to supplement the quantitative data and offer some explanations for low uptake. Focus groups and individual interviews were held with primary child caregivers in Auckland, a major multi-cultural metropolis of New Zealand. A total of 67 parents took part of whom 97% were mothers. Discussion focused on identifying the knowledge and experiences participants had of childhood diseases and immunizations, and on their concerns. Interview data were analysed following construction of role ordered and conceptually clustered matrices. The results demonstrated limited knowledge and a lack of experience regarding childhood diseases. Some mothers conceptualized immunization using a metaphor of ‘protection’. Others perceived immunization as socio-politically driven and were distrustful of immunization campaigns. Many mothers faced a dilemma about immunization and were highly anxious. There was a greater concern about the side effects of immunization than about the side effects of childhood diseases. This may reflect a ‘developed world’ view with a difference between the concerns of white middle class mothers, and those mothers from the Pacific Islands, where common childhood diseases are more endemic. Predominantly the onus for immunization lay with mothers and this was not considered to be sufficiently recognized by health service providers. Personalized programmes designed to meet the needs of mothers are required to complement existing population oriented immunization programmes.