Page 26 - Preventing pertussis in early infancy - Visser

Chapter 2
Qualitative study
Risk perception
In deciding whether to accept pertussis vaccination, all groups evaluated their perception of three risks relative to the vaccination strategy: (1) the risk of pertussis disease for an infant, (2) the risk that they would transmit pertussis to an infant, and (3) their own risks due to vaccination. Within all participant groups, opinions differed on how to cope with risks, ranging from a risk-averse stance to the view that risks are an inevitable part of life.
Risk of pertussis disease for infants
In evaluating the risk of pertussis for infants, the participants considered both the chance that an infant would contract pertussis and the severity of the disease for infants. In all the groups, experience with infant pertussis in the direct environment seemed to influence the evaluations.
Witnessing this child eventually only having some necrotized lung tissue left and actually dying. It made me realise that a simple disease like whooping cough can have major consequences for these little ones.
–Neonatal care nurse
Though participants divided over all groups believed the risk of pertussis to vary for infants, we observed that this belief was most expressed by the professionals. This seemed to mitigate the sense of urgency they felt in relation to their own need of vaccination. For example, they asked if severe pertussis occurs more often in specific groups, such as non- breastfed children. For them, attributing the risk of pertussis to a specific group with a specific behaviour seemed to minimise the risk for the rest of the children, which then made vaccination less important. Furthermore, several participants from all target groups placed the risk of infant pertussis in the context of the total burden of all disease on infants and questioned the priority of pertussis: is it currently the most important disease for a prevention programme?
Risk of transmission to an infant
In assessing whether they might transmit pertussis to an infant, the participants reported two important factors. First, they appraised the risk of contracting pertussis themselves. Experience with adult pertussis in their environment and the view of their own health and immunity status seemed to influence their perception of this risk.
I think my chances of contracting whooping cough are not very high. I figure my body can handle it. I'm healthy enough.
–Maternity assistant
Second, participants assessed the chance of transmitting pertussis to an infant once they had contracted the disease themselves. This came forward most clearly in the interviews with the healthcare professionals. They looked for quantification of this risk and asked what evidence there was that they, as a professional, contributed to transmitting
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