Page 118 - Preventing pertussis in early infancy - Visser

Chapter 7
Chapter 7
vaccination programme. If a specific experience is generally lacking in the target group - such as experience with pertussis in children - this can be substituted by using, for example, peer models explaining their experiences.
Recommendation 4: We recommend that government and public health providers acknowledge that they have a dual role in vaccination programmes, which can lead to the perceived bias among the target groups for vaccination. Together with the societal changes in trust in the government, this issue emphasises the need for maintaining or improving clear and transparent communication as well as nurturing the input of the public in the development of vaccination programmes. We also recommend that maintaining trust of the public is always on the agenda within policy development on a national level.
Recommendation 5: We recommend to consider that vaccinations should preferably be executed by healthcare professionals with whom the target group feel they have a trusted provider-patient relationship.
Recommendation 6: We recommend to consider how a democratic, population based new initiative might be able to address the need to determine the trus tworthiness of information. What this should look like in practice is not directly evident. It might resemble the current developments in the approach to undermine disinformation (‘fake news’), where independent fact checker websites report news to be true or false. However, whether correcting misinformation leads to higher uptake is still subject of debate (Nyhan et al. 2015).
Decisional uncertainty
Our studies indicate that people feel the need to make deliberate decisions on vaccination, but at the same time feel unable to do so. Our results suggest that the reflection on personal and professional values combined with information, personal experiences and views on societal aspects of vaccination, reduces decisional uncertainty and aids decision making. Despite uncertainties on the specific role of reflection on values in the vaccination decision making process, we have developed an online deliberation tool that aims to stimulate and support this reflection.
Recommendation 7: We recommend to facilitate the needs people have to be able to make deliberate choices through supporting and facilitating the reflection on personal and professional values upon vaccination decisions.
Voluntary or mandatory vaccination
Additional to the responsibility respondents showed for making their own decisions, they also indicated to support voluntary vaccination and indicated that mandatory vaccination might lead to adverse effects on trust and uptake. These contextual moral convictions do not regularly inform the current debate on mandatory vaccination policies.
Recommendation 8: We recommend that vaccination policy and practice acknowledge the contextual moral convictions described above. Also, we argue that voluntary vaccination is
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