Page 115 - Preventing pertussis in early infancy - Visser

vaccination) should be avoided and argue that voluntary vaccination is the better option in our context.
Information
Most study participants in the qualitative study (chapter 2) indicated to be in need of information before they could come to a decision on accepting or declining a pertussis cocooning vaccination. They asked many questions about, for instance, the risk to contract pertussis, pertussis vaccine safety, or if there were other options besides vaccination. In their attempt to categorise information and know which information to trust, they valued information based on source, frequency, consistency and scientific base. In chapter 3 we deepened the analysis of the qualitative study and performed an ethically focused re- analysis of the qualitative data, also leading to more insight into the role of information in deliberate decision making for vaccination decisions in the context of our study. We learned that information from public health providers is by some considered to be an insufficient base for a deliberate choice on vaccination, not only because these respondents indicated they were in need for other or more information, but also because they perceived a bias in information originating from public health providers. Consequently, these respondents sought additional information. However, they were unable to get a full picture of the benefits and drawbacks of the vaccination, and therefore did not resolve their uncertainty about the vaccination decision.
The image that these results provide is in line with previous research showing that people are in need of information, but also adds to an understanding of research showing the limited effect on vaccination uptake of interventions based on information alone (Omer et al. 2009, Brown et al. 2010, Larson et al. 2011, Dube et al. 2015). Furthermore, it represents the sociological developments in an era of information overload.
Information in intervention development
From these data we drew the conclusion that people are in need of information, but sometimes perceive information from public health providers as biased. This notion is important, because it indicates that the possibilities of public health providers to inform the public might be limited. Therewith, it underlines the necessity of the public health providers to be clear and transparent in their intentions. In the development of our online deliberation tool we aimed to take the perceived bias of public health providers into account. We focused especially on the support of deciding despite doubts – as described in the paragraph on decisional uncertainty – and not particularly on determining which information to trust and which to distrust. Nevertheless, this inability to know which information to trust could also point to a need for a democratic, population based new initiative to address what information is trustworthy and what is not.
Trust
In the qualitative study (chapter 2) trust was reflected in multiple determinants. Trust seemed to influence respondents’ general vaccination beliefs, their perceived efficacy of pertussis cocooning and their decisional uncertainty. As we described above, trust seems to
General discussion
General discussion
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