Page 78 - Preventing pertussis in early infancy - Visser

Chapter 5
Chapter 5
correlation with the attitudes of maternity assistants and paediatric nurses. The perceived susceptibility of a child to pertussis significantly influences the attitude of midwives toward a pertussis cocooning vaccination. Paranthaman also recently described this aspect of risk perception as a determinant of acceptance (Paranthaman et al. 2016).
In our study, “general vaccination beliefs” include general critical vaccination views, consideration, and naturalistic beliefs. Studies in other vaccination settings have described parts of this determinant. Harmsen (Harmsen 2014) describes the influence of deliberate choice and disease beliefs on the acceptance of the National Immunisation Programme. These items seem identical to our items about consideration and naturalistic beliefs.
In our study, trust in government was reflected in the general beliefs about vaccination policy, and showed an independent association with the attitudes of maternity assistants and paediatric nurses. Trust issues were previously presented as determinants of pertussis cocooning acceptance (Baron-Epel et al. 2012, MacDougall et al. 2015), and they are important in the broader literature about vaccination acceptance (Black et al. 2010, Larson et al. 2011, Yaqub et al. 2014).
To our knowledge, agreement with vaccination policy and perceived cost-benefit have neither been described as determinants of pertussis vaccination acceptance nor as determinants of acceptance in other vaccination settings. In our study, these factors are uniquely associated with attitude in the three target groups. The perceived efficacy of pertussis cocooning was previously described as a determinant of parental and HCW acceptance of pertussis cocooning (Mir et al. 2012). However, this shows significant association only with attitude for the maternity assistants here.
Responsibility reflects the beliefs that express a moral responsibility towards patients to accept a vaccination for preventing pertussis transmission and a notion that acceptance of pertussis cocooning vaccination is part of their professional role. Previously, ethicists presented this line of thinking as an argument in the discussion of mandatory-versus- voluntary vaccination (van Delden et al. 2008, Ottenberg et al. 2011). Such responsibility has not been described in the literature about the determinants of vaccination acceptance. However, some studies indicate that a key reason for HWCs to accept a pertussis cocooning vaccination is to protect their patients (Mir et al. 2012, Vasilevska et al. 2014, Harrison et al. 2016, Paranthaman et al. 2016). This resembles the responsibility described here.
Strengths and limitations
This article presents a complete set of determinants within a robust theoretical framework and is based on the questionnaire results of a large number of respondents (1006 in total). Similar to our previous study of the determinants of parental acceptance of pertussis cocooning, we used an extensive questionnaire based on our previous qualitative study, a literature search, and theory (Visser et al. 2016, Visser et al. 2016). Although our HCW groups showed some result variance, the theoretical framework again provides a good fit.
This study has some limitations. We note that some determinants were measured 78
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