Page 35 - Preventing pertussis in early infancy - Visser

pertussis cocooning vaccination (Top et al. 2010, Bodeker et al. 2014, Lu et al. 2014, Tuckerman et al. 2015). Although a person’s experiences are, of course, inalterable, their importance in decision-making might justify further study of how experience can help in interventions for encouraging acceptance of vaccination.
Studies for improving the acceptance of vaccination often recommend attuning information to the needs of target groups (Hofmann et al. 2006, Hollmeyer et al. 2009, Aguilar-Diaz Fdel et al. 2011). In line with these findings, most study participants indeed needed information; they asked many questions before they formed an opinion about vaccination for pertussis cocooning. In search for answers, they reported to value information based on the source, volume, consistency and scientific base. Knowing what information to trust seemed to be a difficult task, as some participants stated that their search for answers resulted in decisional uncertainty. Notably, part of our participants also stated they perceived public health information biased in favour of vaccination promotion, which added to their uncertainty. This could be understood to be a result of their awareness of the double role a government has in voluntary vaccination programmes: to stimulate vaccination acceptance, while respecting and fostering the public’s autonomous choice on vaccination (O'Neill 2003). It also fits in with the societal change in trust described in the next paragraph. Moreover, it suggests that the power of public health authorities to improve vaccination acceptance through information provision might be restricted.
Other studies in which uncertainty appeared report that providing extra, attuned information had limited effects on vaccination acceptance (Hollmeyer et al. 2013, Nyhan et al. 2014). Some authors even questioned whether information that provides arguments for choosing leads to a decision at all (Mercier et al. 2011). Thus, the role of information in decision-making in vaccination acceptance is controversial. Therefore, attention should be given to alternatives for information provision in vaccination programmes aimed at optimizing acceptance.
Trust is currently a more often debated issue in the literature about vaccination acceptance (Black et al. 2010, Larson et al. 2011, Yaqub et al. 2014). In our findings, the importance of trust is reflected in its influence on the acceptance of pertussis vaccination via the general vaccination beliefs, perceived efficacy, and decisional uncertainty. Trust in government, science, and industry positively influenced acceptance because some participants believed that a vaccination would only be advised if positive outcomes were expected. In contrast, some participants formulated what we called ‘critical vaccination beliefs’ in which distrust was very important. This corresponds with the changes in society toward a risk culture in which manufactured risks seem exceedingly important and lead to the distrust of government, industry, and science (Giddens 1990, Beck 1992). Such a culture has been described in the sociological literature (Blume 2006, Hobson-West 2007, Peretti- Watel et al. 2014, Yaqub et al. 2014). An answer to this trend is not easily found, but we need to give it specific attention in future research about vaccination acceptance.
Qualitative Study
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