Page 36 - Preventing pertussis in early infancy - Visser

Chapter 2
Qualitative study
Differences between target groups
Notably, most determinants were brought forward by parents as well as professionals and were generally comparable in the different groups. Nonetheless, specific groups emphasised certain determinants.
The most remarkable differences were noted between the parents and the healthcare professionals, especially for moral norms, both responsibility and justice. Most parents said they could see vaccination as a part of their responsibility for their child’s health. Professionals, however, saw vaccination having an impact on their personal lives; therefore, they refused to regard it as part of their professional responsibility. This is compatible with Baron-Epel’s qualitative study of pertussis cocooning vaccination (2012).
Furthermore, the healthcare professionals most clearly expressed critical vaccination beliefs, doubts about the risks for the vulnerable infants for whom the programme is designed, and doubts about the expected efficacy of the programme. It is remarkable that the healthcare professionals, who have more knowledge about medicine and science, held more beliefs that seemed to contrast with this background. However, this is in line with studies that identify higher educated parents and healthcare professionals as risk groups for vaccine refusal (Smith et al. 2004, Hak et al. 2005, Gowda et al. 2013). Pereti-Watel (2014) offers an explanation for this phenomenon: the educated middle class is more hesitant about accepting vaccination on the basis of distrust. They seem to know enough to recognise ’manufactured risks’, but too little to discard them as illegitimate science.
Strengths and limitations
This study has some strengths and limitations that should be mentioned. First, it provides insight into a broad range of influencing factors that affect the intention to accept vaccination for pertussis cocooning in the Nether lands. We interview ed parents and healthcare professionals in four differing but relevant target groups, who have close and prolonged contact with newborns. Therefore, our data reflect a comprehensive range of determinants. This is one of the few studies to report a perspective of healthcare professionals as recipients of pertussis cocooning vaccination (rather than providers). Regrettably, we were able to conduct only individual interviews with the neonatal care nurses. However, the influence this had on the results appears limited, since no new themes emerged in these interviews. There could have been some selection bias: people with strong opinions about the subject might have been more inclined to enter the study. However, we met both advocates and opponents of vaccination in the focus group meetings and interviews. As we sampled parents from different socio-economic settings, we trust that most opinions possibly related to socio-economic background were covered. For this reason, we are confident that we have covered the broad array of the target groups’ arguments, both for and against vaccination. As organisation of health care varies between countries, our findings on organisational barriers may be not generalisable for other countries.
Second, the qualitative research method has the advantage of obtaining an in-depth 35
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