Childhood immunisation is one of the most cost effective activities undertaken by health professionals and it has been an important part of the health services in most developed countries for about 200 years.1 From the beginning it has been a complicated programme to deliver, not least because the success of any immunisation programme, as evidenced by a reduction in infectious disease, can lead to complacency on the part of both health professionals and the public. Since the advent of immunisation there have been myths and misconceptions about the safety and value of particular vaccines.2 Unlike most aspects of health care, immunisation programmes are targeted at whole populations, most of whom are perfectly healthy. Because it is important to ensure that as many people as possible receive the service, it is not just a question of passively waiting for parents to avail themselves of it. Immunisation services have to be proactive.

Initially many vaccines have largely sold themselves. For example, the effective introduction of a polio vaccination programme in the 1950s no doubt owed part of its acceptance to the fact that it coincided with a large epidemic.3 Improved media technology in the form of television and photographic coverage of the resultant mortality and morbidity from the disease undoubtedly helped raise public awareness and ensured good uptake of the vaccination, and this has led to the effective demise of acute poliomyelitis. Similarly in 1988, MMR (measles, mumps, and rubella vaccine) was welcomed largely because of the introduction of the mumps component, which was mistakenly believed to have been included because of the link between mumps, orchitis, and the development of sterility in male adults. This myth has been used and misinterpreted by the antivaccination lobby as one reason why MMR is unnecessary,4 rather than giving due prominence …