Page 67 - Preventing pertussis in early infancy - Visser

Introduction
Many countries reported a resurgence of pertussis in recent decades, despite high coverage of the inactivated pertussis vaccine in childhood (Burns et al. 2014, Miller 2014). The reason seems to be a mixture of more awareness, better diagnostics, waning immunity, bacterial changes in the circulating pertussis strains (Cherry 2012, Mooi et al. 2014), and more frequent vaccine hesitancy (Phadke et al. 2016). Such resurgence particularly threatens young infants, who are vulnerable to severe pertussis complications and who only receive adequate protection after completing the primary series of vaccinations at the age of 6 months (Kilgore et al. 2016).
The increased pertussis incidence has led to pertussis outbreaks in healthcare settings (including neonatal care) (Leekha et al. 2009, Maltezou et al. 2013, Heininger 2014) in which healthcare workers (HCWs) are apparently either the introductory source or part of the transmission chain. Apart from the morbidity and mortality among infants who contract pertussis during hospitalisation, nosocomial pertussis outbreaks generate considerable costs for containment strategies, antibiotic prophylaxis or therapy, and sometimes ad hoc vaccination strategies (Daskalaki et al. 2007, Leekha et al. 2009, Tariq et al. 2015). In high- income countries, a pertussis booster vaccination for HCWs has been recommended, as part of a cocooning strategy aiming to prevent transmission to patients, particularly young infants (Commission 2000, Wirsing von Konig et al. 2005, Miller 2014). Introducing such a strategy might also reduce costs (Daskalaki et al. 2007, Greer et al. 2011, Tariq et al. 2015). The USA, Australia, and nine European countries have adopted these recommendations and introduced pertussis booster vaccination for HCWs and other close contacts in a cocooning strategy to prevent pertussis transmission to infants (Maltezou et al. 2014).
However, pertussis vaccination uptake among HCWs in high-income countries is reportedly a problematic 11%–85% (Peadon et al. 2007, Guthmann et al. 2012, Mir et al. 2012, Lu et al. 2014, MacDougall et al. 2015, Ryser et al. 2015, Tuckerman et al. 2015, Walther et al. 2015, Harrison et al. 2016, Maltezou et al. 2016, Paranthaman et al. 2016). A vaccination programme designed to carefully target the barriers and enablers of acceptance could ensure optimal uptake. This programme would require a coherent theory- and evidence-based approach (Grimshaw et al. 2012, Grol 2013, Baker et al. 2015, Kok et al. 2016). Insight into the determinants influencing the acceptance of pertussis vaccination by HCWs is crucial. Therefore, this study aims to assess the intention of HCWs to accept a pertussis cocooning vaccination and to examine and quantify the determinants that influence this intention.
Methods
Study design and population
In our cross-sectional questionnaire study among Dutch HCWs we targeted maternity assistants, midwives, and paediatric nurses specifically. A possible future programme of
Quantitative study HCWs
Quantitative study HCWs
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