Page 76 - Preventing pertussis in early infancy - Visser

Chapter 5
Chapter 5
Discussion
The numbers of HCWs who intended to accept pertussis cocooning vaccination differed among the three target groups in our study. The determinants influencing the intentions of all groups to accept vaccination include attitude, anticipated affect regarding non-acceptance, and decisional uncertainty. Social norm, perceived capacity, anticipated negative affect regarding acceptance, and previous acceptance of influenza vaccination influenced the intentions in one or two groups. The attitude toward pertussis cocooning vaccination in all HCW groups was further explained by general vaccination beliefs, agreement with policy advice to vaccinate HCWs, perceived cost-benefit ratio, and perceived personal responsibility to prevent pertussis.
Intention
The intention rates in this study can be classified as low. Considering the well-known intention-behaviour gap would make the actual uptake in this population even lower (Sheeran P. Strobe W 2002).
Only a few previous studies describe the intention of HCWs to accept a pertussis vaccination. The results range from 15% to 76% (Goins et al. 2007, Top et al. 2010, Taddei et al. 2014). The intention to accept a pertussis vaccination in this study is comparable to the reported actual acceptance in most studies coming from countries where a HCW pertussis booster is recommended and voluntary (range 46%–75%) (Peadon et al. 2007, Mir et al. 2012, MacDougall et al. 2015, Ryser et al. 2015, Tuckerman et al. 2015, Walther et al. 2015). Some studies report a lower vaccination uptake (range 11%–30%) (Guthmann et al. 2012, Lu et al. 2014). However, one has recently reported a high uptake of over 85% (Paranthaman et al. 2016), which could be credited to the specific timing of the pertussis campaign: it took place during a local pertussis outbreak.
Previous studies of pertussis cocooning acceptance report differences in vaccination uptake among HCWs. These studies show that the acceptance rate of pertussis cocooning vaccination is generally lower among nurses than other HCWs (Peadon et al. 2007, Baron- Epel et al. 2012, Guthmann et al. 2012, Ryser et al. 2015). This is consistent with our data. To our knowledge, only Guthmann’s study (Guthmann et al. 2012) reports the pertussis vaccination coverage among midwives; namely, 43.8%, comparable to the 53.0% in this study. Notably, the acceptance of pertussis cocooning has only been described for HCWs who work in hospitals, whereas most maternity assistants and midwives in our study work outside the hospital.
Determinants of intention
Several vaccination acceptance studies in different settings for various vaccines show that attitude, social norm, and perceived capacity (or self-efficacy) are important predictors of the intention to accept vaccination (Fisher et al. 2013, van Keulen et al. 2013, Corace et al. 2016, Myers 2016). This agrees with our findings. In studies of the HCW acceptance of
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