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The MMR Vaccine

A Case Study of Policy Stability

Glasgow Caledonian University, UK, Ruth.Webster{at}gcal.ac.uk

The policy on mass childhood immunization is an established element of the UK's approach to public health. During the late 1990s the triple measles, mumps and rubella (MMR) vaccine was the subject of widespread concern vis-a-vis its possible link with bowel disorders and autism. The government resisted calls for policy change despite a decline in MMR uptake. Why did the government continue to support MMR? The article explores this question and advances a possible explanation of policy stability in the face of pressure for policy change. It draws on the advocacy coalition framework to examine the immunization policy process, analyse the role of expert advice and contrast the relative strength of the government's case with the relative weakness of those actors advocating policy change. While the advocacy coalition framework helps to frame the analysis, it is an imperfect fit for the case study. Instead of a policy subsystem of competing advocacy coalitions, the case reveals a dominant group of actors (likened to a policy fortress) presiding over immunization policy. It is suggested that the presence of such a group would make it difficult for all but the most highly organized, strategically minded actors to advance their cause.

Key Words: advocacy coalitions • health policy • implementation • pressure groups

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