Page 17 - Preventing pertussis in early infancy - Visser

Thesis objectives
In sum: since the resurgence of pertussis in the past two decades, additional vaccination strategies are needed to prevent pertussis in early infancy. When we set out the research that is the basis for this thesis, pertussis cocooning and selective vaccination of HCWs who work with infants were the strategies that would most likely be implemented within the Netherlands. We knew, however, that the uptake of such new vaccination strategies would not be self-evident upon introduction, and consideration of the factors influencing this uptake would be essential. The ultimate aim of this thesis is therefore to design a tailored, theory- and evidence based implementation strategy for pertussis cocooning vaccination and selective vaccination of HCWs. During our research period the Health Council of the Netherlands issued the advice to implement both maternal pertussis vaccination (2015) - and thereby not pertussis cocooning - as well as specific vaccination for HCWs (2017). This slightly shifted the specific focus towards HCWs for the design of a vaccination programme, and we formulated our research questions as follows:
Research questions:
1. Which determinants (barriers or enablers) influence the acceptance of pertussis cocooning vaccination in parents and the selective vaccination of healthcare workers against pertussis?
2. How can we systematically develop a theory- and evidence based programme for the selective vaccination of healthcare workers against pertussis, using an Intervention Mapping approach?
Thesis outline
This thesis is divided into three parts. We first describe a qualitative exploration of determinants influencing the acceptance among the potential target groups of pertussis cocooning vaccination and selective vaccination of HCWs who work with infants (chapters 2 and 3). The study presented in chapter 2 qualitatively explores the perceived determinants (barriers as well as enablers) of intention to accept pertussis vaccination in both parents and various groups of healthcare professionals in the Netherlands, and it describes the differences between the groups that were interviewed. In chapter 3 we provide more in- depth reflection on the implications of the qualitative data in relation to the ethical discussion on mandatory versus voluntary vaccination, with a focus on the role of information. The second part of this thesis aims to quantify the results of the qualitative studies in both parents (chapter 4) and HCWs (chapter 5) by assessing their intention to accept a pertussis cocooning vaccination and the determinants that influence this intention. In the third part of this thesis (chapter 6) the previously collected data on the determinants of pertussis cocooning acceptance is assembled and used while applying Intervention Mapping for the planning and design of a pertussis vaccination programme for HCWs. Finally, in chapter 7 we discuss our findings and the implications for public health practice, policy and further research.
General Introduction
General introduction
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