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Intention to Accept Pertussis Vaccination for Cocooning: A Qualitative Study of the Determinants
Olga Visser1, Jeannine L A Hautvast1, Koos van der Velden1
1Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands.
Insights
Pertussis vaccination for infants
Area of Science:
- Public Health
- Vaccinology
- Behavioral Science
Background:
- Pertussis (whooping cough) resurgence poses risks to unvaccinated infants.
- Cocooning vaccination strategy aims to protect infants by immunizing their close contacts.
- Understanding vaccination acceptance is crucial for effective public health interventions.
Purpose of the Study:
- To identify perceived barriers and facilitators influencing the intention to accept pertussis cocooning vaccination.
- To explore determinants of vaccination acceptance among key target groups in the Netherlands.
- To inform the optimization of pertussis cocooning vaccination programs.
Main Methods:
- 13 focus groups and 6 semi-structured interviews conducted with parents, maternity assistants, midwives, and paediatric nurses.
- Topic list based on literature review and a barrier framework.
- Thematic content analysis of transcribed interviews.
Main Results:
- Intention to accept pertussis cocooning vaccination was influenced by risk perception, outcome expectations, general vaccination beliefs, moral norms, social influences, perceived autonomy, anticipated regret, decisional uncertainty, and organizational barriers.
- Perceived cost-effectiveness, justice, anticipated regret, and decisional uncertainty were novel determinants identified.
Conclusions:
- Nine perceived determinants influence the intention to accept pertussis cocooning vaccination.
- Experience, information, and trust are predominant themes requiring attention in policy and practice.
- Recommendations include considering identified determinants to enhance vaccination program uptake and effectiveness.
Context:
Several countries have reported a resurgence of pertussis in the last decades. This puts infants (especially <6 months) at risk of severe complications, because they are too young to be fully protected by vaccination. The global pertussis initiative has proposed pertussis vaccination of young infants' close contacts, in order to reduce pertussis transmission and the burden of the disease on infants. Our aim is to explore the perceived determinants (barriers and facilitators) of intention to accept vaccination among the possible target groups of pertussis vaccination for cocooning. Consideration of these determinants is necessary to optimise the uptake of the vaccination.
Methods:
We conducted 13 focus groups and six individual semi-structured interviews with members of possible target groups for pertussis cocooning (i.e. parents, maternity assistants, midwives, and paediatric nurses) in the Netherlands. Here, both maternal pertussis vaccination as well as pertussis cocooning has not been implemented. The topic list was based on a literature review and a barrier framework. All interviews were transcribed verbatim and two researchers performed thematic content analysis.
Findings:
The participants' risk perception, outcome expectations, general vaccination beliefs, moral norms, opinion of others, perceived autonomy, anticipated regret, decisional uncertainty, and perceived organisational barriers were all factors that influenced the intention to accept pertussis vaccination for cocooning.
Discussion:
This study has identified nine perceived determinants that influence the intention to accept pertussis cocooning vaccination. We add the following determinants to the literature: perceived cost-effectiveness (as a concept of outcome expectations), justice (as a concept of moral norms), anticipated regret, and decisional uncertainty. We recommend considering these determinants in vaccination programmes for pertussis cocooning vaccination. Experience, information and trust emerged as predominant themes within these determinants. These themes require particular attention in future research on vaccination acceptance, especially with regard to their role in use and implementation in policy and practice.
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