© 2004 BMJ Publishing Group & Royal College of Paediatrics and Child Health
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In my early travels to the UK I was struck by the very different attitudes about immunisations. The controversy over the alleged link between MMR and autism lingers, which has obviously influenced the acceptance of other vaccines. However, because the UK healthcare system actually tries to contain cost before widespread use—regardless of parent attitudes—the benefits of each vaccine is carefully considered. Hence, there is little use of either varicella or pneumococcal conjugate vaccines. As immunisations are introduced that prevent relatively uncommon disease (invasive pneumococcal disease compared with Haemophilus influenzae type B disease) or reduce morbidity rather than mortality (like varicella and flu vaccines), physician and parent acceptance of new vaccines may be increasingly complicated. Even in the US, the uptake of varicella vaccine has been slow. I suspect it will be a challenge to gain widespread acceptance of human papilloma and herpes simplex virus vaccines in the US, since they
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