Page 28 - Preventing pertussis in early infancy - Visser

Chapter 2
Qualitative study
Perceived efficacy
To assess the efficacy, the participants asked themselves: how effective will cocooning be in preventing pertussis in infants? In considering their answers, the participants repeatedly said that the state of the scientific work proving the intervention would be effective was crucial for forming an opinion. This stood out especially in the opinions of the midwives, although all the participating groups said that the evidence base for the strategy was important.
How the participants perceived the efficacy of cocooning seemed to be shaped by (1) the effect of cocooning in other countries, (2) the perceived efficacy of the vaccine itself, (3) the participants’ trust in the government, (4) their opinions of the extent of the cocooning programme (i.e. which target groups would be included), and (5) future vaccination uptake. For example, some participants divided among all target groups argued that vaccination in general no longer seems to be a matter of course. Now it is difficult to close a circle of protection around an infant, which diminishes the potential effect of cocooning. In all different groups, others stated that the government does not take their responsibility for vaccination advice lightly. Therefore, if the government advised pertussis vaccination, they would trust it as an effective strategy.
And the usefulness. I would like the results to be examined 10 years later to see whether it was any use vaccinating everybody and whether these numbers will have indeed decreased. –Midwife
Perceived cost-effectiveness
To evaluate the cost-effectiveness, the participants questioned whether the benefits would outweigh the money and effort the government had to invest. This question came forward in all the groups, but the midwives stated it most specifically. Others (from all groups) said that the efficacy should be optimal to achieve a balance, and they believed the whole population should be re-vaccinated.
It may sound harsh, but all this to save one baby. Consider the costs and the system that has to be set up. Macro-economically, this makes you wonder whether it is really worthwhile. –Parent
General vaccination beliefs
The opinions of vaccination in general are reflected in the evaluation of pertussis vaccination in the context of cocooning. Some participants stated that vaccination in general is routine; for them, it is just the normal thing to do. They trusted the government or science to prescribe a vaccination only if it was unquestionably ‘a good idea’. Not all people for whom the National Immunisation Programme (NIP) was routine automatically thought pertussis cocooning was routine as well. Mainly parents expressed this view.
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