Determining Factors for Pertussis Vaccination Policy: A Study in Five EU Countries

Area of Science:

• Public Health
• Immunology
• Vaccinology

Background:

• Pertussis vaccination policies exhibit significant variation across European nations.
• Policies differ in vaccine type (whole-cell vs. acellular), immunization schedules, and recommendations for parental immunization.

Purpose of the Study:

• To investigate the key factors determining pertussis vaccine policy in Europe.
• To analyze the influences on vaccine type selection, infant immunization schedules, and maternal immunization recommendations.

Main Methods:

• Semi-structured interviews were conducted with national health experts from Denmark, France, Poland, Sweden, and the UK.
• Thematic analysis of interview transcripts was performed using a pre-defined codebook with inter-coder agreement assessment.
• Fifteen expert interviews were analyzed to identify driving factors.

Main Results:

• Driving factors for pertussis vaccine policy were categorized into scientific, sociological, and pragmatic domains.
• Vaccine type choice was influenced by prescriber preference, adverse event concerns, effectiveness, and combined vaccine considerations.
• Infant schedule decisions were driven by immune response, coverage, and timeliness; maternal immunization by infant mortality and public acceptance.

Conclusions:

• Pertussis vaccine policy decisions are shaped by a complex interplay of scientific, sociopolitical, and pragmatic considerations.
• Beyond scientific data, societal views and practical implementation challenges significantly impact vaccine policy formulation and recommendations.