Preventing pertussis in early infancy: development of a strategy for implementing pertussis vaccination of new parents and healthcare workers

Vaccinations remains of great importance to allow children to grow up safely and healthy. Infants who are too young to be protected by their own childhood vaccinations, are safer if the adults in their environment are vaccinated against pertussis. Once vaccinated, it is prevented that these adults play a role in the transmission chain of pertussis to infants. For an effective implementation of such a vaccination strategy, most theories on behavioural change emphasise that a vaccination programme should take account of a broad array of determinants that influence the vaccination acceptance in the target groups. In this thesis we elaborate on these determinants and describe the reasons why parents and healthcare workers who work with infants would accept or decline a pertussis vaccination if it were to be offered to them. Using Intervention Mapping we designed a future pertussis cocooning vaccination programme, taking the most relevant and changeable determinants into account. We found that experience, information and trust are important themes concerning the acceptance of pertussis vaccination among parents and healthcare workers. The studies show that a positive attitude, and anticipated regret regarding the decline of a vaccination increase the acceptance. Decisional uncertainty influences the acceptance negatively. Furthermore, our research indicates that mandatory vaccination continues to be the better alternative in the Dutch context. In order to better attune vaccination programmes to these findings, we suggest that more effort should be put in helping people to deal with the difficulty they experience in making a deliberate choice about vaccination. We recommend that a pertussis vaccination offer for parents or healthcare workers should not only be accompanied by sufficient information and elaborate on experiences, but also by support in informed decision making suiting their personal and professional values