Hidden needs: identifying key vulnerable groups in data collections. Vulnerable migrants, Gypsies and Travellers, homeless people, and sex workers. 2014. (accessed 7 July 2020)

A review of the literature on the health beliefs, health status, and use of services in the Gypsy Traveller population, and of appropriate health care interventions. 2005. (accessed 7 July 2020)

Condon LJ, Salmon D. ‘You likes your way, we got our own way’: Gypsies and Travellers' views on infant feeding and health professional support. Health Expect. 2015; 18:(5)784-795

Condon L, Bedford H, Ireland L Engaging Gypsy, Roma, and Traveller communities in research: maximizing opportunities and overcoming challenges. Qual Health Res. 2019; 29:(9)1324-1333

Dar O, Gobin M, Hogarth S, Lane C, Ramsay M. Mapping the Gypsy Traveller community in England: what we know about their health service provision and childhood immunization uptake. J Public Health (Bangkok). 2013; 35:(3)404-412

Dixon KC, Mullis R, Blumenfeld T. Vaccine uptake in the Irish Travelling community: an audit of general practice records. J Public Health (Oxf). 2017; 39:(4)e235-e241

Feder G, Vaclavik T, Streetly A. Traveller Gypsies and childhood immunization: a study in east London. Br J Gen Pract. 1993; 43:(372)281-284

Jackson C, Bedford H, Cheater FM Needles, jabs and jags: a qualitative exploration of barriers and facilitators to child and adult immunisation uptake among Gypsies, Travellers and Roma. BMC Public Health. 2017; 17:(1)

Jackson C, Bedford H, Condon L UNderstanding uptake of Immunisations in TravellIng aNd Gypsy communities (UNITING): protocol for an exploratory, qualitative study. BMJ Open. 2015; 5:(6)

Maduma-Butshe A, McCarthy N. The burden and impact of measles among the Gypsy-Traveller communities, Thames Valley, 2006-09. J Public Health (Bangkok). 2013; 35:(1)27-31

McFadden A, Siebelt L, Gavine A Gypsy, Roma and Traveller access to and engagement with health services: a systematic review. Eur J Public Health. 2018; 28:(1)74-81

Parry G, Van Cleemput P, Peters J, Walters S, Thomas K, Cooper C. Health status of Gypsies and Travellers in England. J Epidemiol Community Health. 2007; 61:(3)198-204

Pinkney K. The practice and attitudes of Gypsy and Traveller women towards early infant feeding. Community Pract. 2012; 85:(7)26-29

Siebelt L, Jackson C, MacFadden A, Dyson L, Atkin K. Use of UK health services by Gypsies, Roma, and Travellers: triangulation of two mixed methods studies. Meeting Abstracts. Lancet. 2017; 390:(Special Issue)

Smart H, Titterton M, Clark C. A literature review of the health of Gypsy/Traveller families in Scotland: the challenges for health promotion. Health Education. 2003; 103:(3)156-165

Smith D, Newton P. Structural barriers to measles, mumps and rubella (MMR) immunisation uptake in Gypsy, Roma and Traveller communities in the United Kingdom. Critical Public Health. 2017; 27:(2)238-247

Gypsy and Roma Travellers. JSNA needs assessment. Kingston. 2016. (accessed 7 July 2020)

Influences on childhood immunisation decision-making in London's Gypsy and Traveller communities

23 July 2020
Volume 29 · Issue 14



Uptake of childhood immunisations is lower among Gypsy, Roma and Traveller (GRT) communities than in the general UK population. This small-scale study aimed to elicit insights from GRT mothers on their interaction with health services in London around childhood immunisations. The purpose was to inform a larger piece of work by the NHS England and Improvement (London) Public Health Commissioning Team to inform their planning to improve access to vaccination services for GRT communities in London.

Study design:

An exploratory qualitative study using semi-structured interviews and a focus group.


There was purposive sampling of mothers from any GRT background from south-west London using snowballing methods. One focus group and three interviews were conducted. A thematic analysis approach was used.


A total of nine women were recruited and seven participated between March and April 2018. Five themes were identified: adherence with antenatal care, self-declared parenting expertise, family support, childhood immunisations, keep children healthy but ‘they say wait on the MMR until they are talking’.


Compliance with antenatal care, strong parenting beliefs and cohesive family support are strong influences on decision-making regarding immunisations. The women interviewed emphasised their own expertise in child rearing. This was occasionally at odds with the health advice provided by health professionals. The women widely shared their experiences of health professionals with other family and community members and this impacted on others' intention to vaccinate. These are key issues that should be considered when trying to improve uptake of immunisations in GRT families in a face-to-face manner. Equally, it warrants further exploration in a larger-scale study to see whether this reflects the wider community and in order to tailor supplementary immunisation activities to improve uptake.

Gypsy, Roma and Traveller (GRT) communities are among the most disadvantaged minority groups in Europe, experiencing poorer infant and child health outcomes (Smart et al, 2003) and greater maternal and child mortality than the general population (Aspinall, 2005; Parry et al, 2007; Aspinall, 2014). They are also less likely to access health services; facing barriers related to discrimination, culture and language, health literacy, service-user attributes, and economic barriers (Siebelt et al, 2017; McFadden et al, 2018). In the UK, GRT communities have been identified as having a lower uptake of childhood immunisations than in the general population, significantly increasing the risk of vaccine-preventable disease among children and families (Pinkney, 2012; Dar et al, 2013; Dixon et al, 2017).

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