Page 60 - Preventing pertussis in early infancy - Visser

Chapter 4
Quantitative study parents
Discussion
The majority of the parents (78.0%) in this study are willing to accept a pertussis cocooning vaccination if offered to them. This intention to accept vaccination was explained by their attitude towards pertussis cocooning vaccination and the expectation to experience negative feelings when their child would be infected with pertussis following a decision not to vaccinate. Decisional uncertainty and anticipated negative affect of acceptance appeared to contribute negatively to the intention to accept a pertussis cocooning vaccination.
Table 3. Univariate and multivariate linear regression analysis of the determinants of parental attitude on pertussis cocooning vaccination (N=275).
Determinants*
Risk perception
Susceptibility pertussis child
Severity pertussis self
Susceptibility transmission pertussis Susceptibility side effects vaccination Severity side effects vaccination
General vaccination beliefs Outcome expectations #
Perceived efficacy
Cost benefit Moral norm
Univariate analysis
β**(95% CI)
0.31 (0.21-0.41) 0.21 (0.12-0.32) 0.10 (0.01-0.19) -0.52 (-0.63--0.40) -0.32 (-0.43--0.21)
0.90 (0.80-1.00)
0.70 (0.57-0.82) 0.43 (0.33-0.54) 0.59 (0.51-0.66)
Multivariate analysis~
p β** (95% CI)
p .004
<.001 .011 <.001
<.001 <.001 .028 <.001 <.001
<.001
<.001 <.001 <.001
0.10 (0.03-0.17)
0.58 (0.45-0.71) 0.15 (0.04-0.27) 0.22 (0.12-0.31)
* measured on 7 point Likert scale; low-high
**For each point increase on the Likert scale of the determinant, the intention changes with the value o f β. ~ R2 0.619
# n = 274
Further analyses showed unique contributions of general parental vaccination beliefs, moral norm, beliefs concerning their infants’ susceptibility for pertussis, and expectations on the efficacy of cocooning in the explanation of attitude.
Intention
The percentage of parents in this study that intent to accept pertussis cocooning is comparable to other studies. (Beel et al. 2013, Rossmann Beel et al. 2014, Dempsey et al. 2015). However, this rate appears to be high in comparison to studies that report the actual acceptance of pertussis cocooning vaccination for countries in which the cocooning strategy is already advised. Bodeker (Bodeker et al. 2014), for instance, reported an acceptance of 22% among women with children <1 year in Germany. In the United States (25.9% and 34.0%) (Suryadevara et al. 2014, Williams 2014), France (16.4%)(Baratin et al. 2014) and Australia (33.7% and 23.1%) (Wong et al. 2015, Hayles et al. 2016), similar rates have been reported. However, if vaccination programmes had been put into place, which addressed this low uptake, the reported acceptance increased to 70-90% (Healy et al. 2011, Camenga et al. 2012, Leboucher et al. 2012, Hayles et al. 2015). These numbers indicate that it is possible to bridge the well-known intention-behaviour gap and achieve an acceptance as
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