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CELLA PAOLA, VOGLINO GIANLUCA, BARBERIS ILARIA, ALAGNA ENRICO, ALESSANDRONI CLAUDIA, CUDA ALESSANDRO, D’ALOISIO FRANCESCO, DALLAGIACOMA GIULIA, DE NITTO SARA, DI GASPARE FRANCESCA, GALLIPOLI ORIANA, GENTILE LEANDRO, KUNDISOV LUCIA, NAVARO MONICA, PROVENZANO SANDRO, SANTANGELO OMARENZO, STEFANIZZI PASQUALE, GIANFREDI VINCENZA. Resources for assessing parents' vaccine hesitancy: a systematic review of the literature. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2020; 61:E340-E373. [PMID: 33150224 PMCID: PMC7595070 DOI: 10.15167/2421-4248/jpmh2020.61.3.1448] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 07/22/2020] [Indexed: 11/17/2022]
Abstract
The concept of Vaccine Hesitancy has begun to appear in the scientific landscape, referring to the reluctance of a growing proportion of people to accept the vaccination offer. A variety of factors were identified as being associated with vaccine hesitancy but there was no universal algorithm and currently there aren’t any established metrics to assess either the presence or impact of vaccine hesitancy. The aim of this study was to systematically review the published questionnaires evaluating parental vaccine hesitancy, to highlight the differences among these surveys and offer a general overview on this matter. This study offers a deeper perspective on the available questionnaires, helping future researches to identify the most suitable one according to their own aim and study setting.
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Affiliation(s)
- PAOLA CELLA
- Post Graduate School of Hygiene and Preventive Medicine, Department of Medicine and Surgery, University of Parma, Italy
| | - GIANLUCA VOGLINO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Public Health, University of Turin, Italy
| | - ILARIA BARBERIS
- Health Science Department, University of Genoa, Italy
- Correspondence: Ilaria Barberis, Health Science Department, University of Genoa, largo Rosanna Benzi 10, Pad. 3 San Martino Hospital, Italy - Tel./Fax +39 010 3538502 - E-mail:
| | - ENRICO ALAGNA
- Post Graduate School of Hygiene and Preventive Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, Italy
| | - CLAUDIA ALESSANDRONI
- Post Graduate School of Hygiene and Preventive Medicine, University of Rome Tor Vergata, Rome, Italy
| | - ALESSANDRO CUDA
- Post Graduate School of Hygiene and Preventive Medicine, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - FRANCESCO D’ALOISIO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Life, Health and Environmental Sciences, University of L’Aquila, Italy
| | - GIULIA DALLAGIACOMA
- Post Graduate School of Hygiene and Preventive Medicine, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - SARA DE NITTO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Italy
| | - FRANCESCA DI GASPARE
- Post Graduate School of Hygiene and Preventive Medicine, University of Rome Tor Vergata, Rome, Italy
| | - ORIANA GALLIPOLI
- Post Graduate School of Hygiene and Preventive Medicine, Department of Life, Health and Environmental Sciences, University of L’Aquila, Italy
| | - LEANDRO GENTILE
- Post Graduate School of Hygiene and Preventive Medicine, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - LUCIA KUNDISOV
- Post Graduate School of Public Health, University of Siena, Italy
| | - MONICA NAVARO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Experimental Medicine, University of Campania “L. Vanvitelli”, Italy
| | - SANDRO PROVENZANO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, Italy
| | - OMAR ENZO SANTANGELO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, Italy
| | - PASQUALE STEFANIZZI
- Post Graduate School of Hygiene and Preventive Medicine, Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Italy
| | - VINCENZA GIANFREDI
- Post Graduate School of Hygiene and Preventive Medicine, Department of Experimental Medicine, University of Perugia, Italy
- School of Medicine, University Vita-Salute San Raffaele, Milan, Italy
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Decreasing Vaccination Coverage Against Hepatitis B and Tuberculosis in Newborns. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020. [PMID: 31705322 DOI: 10.1007/5584_2019_446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register]
Abstract
The number of parents who refuse to vaccinate their children or present the so-called hesitant behavior, i.e., delay the moment of vaccination beyond the mandatory time, has increased in many developed countries. The purpose of this retrospective study was to evaluate the completeness and timeliness of vaccinations against hepatitis B (HBV) and tuberculosis (TB) in neonates in a single maternity hospital in Warsaw, Poland. We reviewed medical files of 14,785 children born in the hospital in 2015-2017 and calculated the proportion of newborns not vaccinated on time according to the Polish Immunization schedule that includes vaccination against HBV and TB in the first day of life. Newborns remained unvaccinated because of parental refusal (refusers) or decision for a delay (hesitants), or medical contraindications. The percentage of unvaccinated newborns in the 3 years was as follows: 7.3% in 2015, 6.7% in 2016, and 10.1% in 2017. Parental decisions rather than medical contraindications caused nonvaccination (4.4% vs. 2.9% in 2015, 4.7% vs. 2.0% in 2016, and 7.5% vs. 2.6% in 2017). The majority of refusals concerned both vaccinations (67.3% in 2015, 74.8% in 2016, and 68% in 2017). Among parents who refused only one vaccination, TB vaccination was refused more often than HBV (9.2% vs. 7.1% in 2015, 8.3% vs. 5.7% in 2016, and 5.9% vs. 2.7% in 2017). Similar trends were observed among the hesitants. In conclusion, it seems essential to implement effective educational and informative activities targeted to parents to reinforce positive attitudes toward vaccinations.
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Wu JN, Zhou Y. Factors associated with and screening models of national immunization programme vaccine series completion among preschool children in Fujian Province, south-eastern China. J Infect Public Health 2018; 12:236-241. [PMID: 30442526 DOI: 10.1016/j.jiph.2018.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 10/21/2018] [Accepted: 10/23/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND An effective method for the rapid identification of vulnerable preschool children at risk of not completing the national immunization programme (NIP) vaccine series in China is still lacking. METHODS A cross-sectional study involving 772 preschool children born between September 1 2009 and August 31, 2011 was conducted in 2015 in Fujian Province, south-eastern China. The data were collected by face-to-face interviews with the parents or guardians of the children using a standard questionnaire. RESULTS Children who received the first dose of a hepatitis B vaccine (HepB) less than 24h after birth and those who received one or more doses of surrogate for-fee vaccines (SFVs) were more likely to complete the NIP vaccine series with adjusted odds ratios (ORs) of 3.12 (95% confidence interval [CI]: 1.19-8.23) and 4.74 (1.41-15.90), respectively. The cut-off value of the prediction score for the completion of the NIP vaccine series was 92.5%, and the sensitivity, specificity, and positive and negative predictive values were 87.5%, 47.1%, 11.4% and 98.0%, respectively. CONCLUSIONS The receipt of a timely first dose of HepB and one or more doses of SFVs were associated with and good predictors of NIP vaccine series completion by preschool children in Fujian, China.
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Affiliation(s)
- Jiang-Nan Wu
- Department of Clinical Epidemiology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, 200011, China.
| | - Yong Zhou
- Fujian Provincial Centers for Disease Control and Prevention, Fuzhou, 350000, China.
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Wu JN, Li DJ, Zhou Y, Du MR, Piao HL. Relationship between receipt of substitutable for-fee vaccines and completion of the expanded programme on immunisation: a cross-sectional study in Fujian, China. BMJ Open 2017; 7:e015666. [PMID: 28729316 PMCID: PMC5642657 DOI: 10.1136/bmjopen-2016-015666] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the relationship between receipt of the substitutable-for-fee vaccines (SFV) and completion of the expanded programme on immunisation (EPI). DESIGN AND SETTINGS A cross-sectional study was conducted in Fujian province, China. PARTICIPANTS Children who were born from 1 September 2009 to 31 August 2011, and who had been residing in the township for at least 3 months, were randomly recruited from 34 townships. MAIN OUTCOMES MEASURES Outcomes were completion rate of the EPI and coverage rate of the SFV. RESULTS The study included 1428 children, of whom 1350 (94.5%) finished the EPI and 282 (19.7%) received at least one dose of the SFV. Administration of the SFV was associated with an increased likelihood of completing the EPI (OR=3.2, 95% CI 1.3 to 7.6 in the total sample and OR=4.0, 95% CI 1.7 to 9.6 in the subsample of children in regions with the SFV accessibility). The impact of the SFV administration on completion of the EPI was larger among children whose parents have junior school education or less (97.8% and 97.9% vs 92.5% and 91.9%, both p<0.001) and among those with a timely hepatitis B vaccine first dose (98.5% vs 94.0%, p<0.001). CONCLUSIONS Receipt of SFV is associated with increased likelihood of completion of the EPI in Fujian, China.
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Affiliation(s)
- Jiang-Nan Wu
- Department of Clinical Epidemiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Da-Jin Li
- Department of Clinical Epidemiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Yong Zhou
- Department of Expanded Programme on Immunization, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Mei-Rong Du
- Department of Clinical Epidemiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Hai-Lan Piao
- Department of Clinical Epidemiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
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Wu JN, Li DJ, Zhou Y. Association between timely initiation of hepatitis B vaccine and completion of the hepatitis B vaccine and national immunization program vaccine series. Int J Infect Dis 2016; 51:62-65. [PMID: 27592194 DOI: 10.1016/j.ijid.2016.08.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 08/22/2016] [Accepted: 08/23/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Little is known about the association between the initiation of hepatitis B vaccine (HB vaccine) at birth and completion of the HB vaccine and the national immunization program vaccine (NIPV) series in Fujian, China. METHODS A provincial survey, including children in the community and newborns in hospital, was conducted to evaluate coverage with a timely first dose of HB vaccine and the completion of three doses of HB vaccine and the NIPV series in 2013. A proportion of the samples was rechecked to investigate the relationship between the administration of a timely first dose of HB vaccine and completion of the HB vaccine series and the NIPV series (three doses of HB vaccine, one dose of Bacillus Calmette-Guérin vaccine, three doses of oral poliomyelitis vaccine, three doses of diphtheria-tetanus-pertussis vaccine, one dose of measles-containing vaccine, one dose of Japanese encephalitis attenuated live vaccine, and two doses of group A meningococcal polysaccharide vaccine). RESULTS A total of 6589 subjects (including 3785 community children and 2804 hospital newborns) were included in this study; 97.34% of them received a timely first dose of HB vaccine (≤24h after birth) and 99.10% and 88.27% completed the HB vaccine series and the NIPV series, respectively. Among the 1680 children from eight counties who were rechecked, those with a timely first dose of HB vaccine had higher completion rates of the HB vaccine series and the NIPV series than those with a delayed first dose of HB vaccine (99.69% and 88.90% vs. 83.05% and 79.66%, respectively; both p<0.001). Compared to those with a delayed HB vaccine first dose, the odds ratios for completing the HB vaccine series and the NIPV series among children who received a timely first dose of HB vaccine were 65.96 (95% confidence interval (CI) 21.73-200.25) and 3.24 (95% CI 1.81-5.81), respectively. CONCLUSIONS Coverage with a timely first dose of HB vaccine is high in children in the community and newborns in hospital, and timely receipt of the first dose of HB vaccine is associated with an increased likelihood of completing the HB vaccine series and the NIPV series in Fujian, China.
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Affiliation(s)
- Jiang-Nan Wu
- Department of Clinical Epidemiology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, PR China.
| | - Da-Jin Li
- Department of Clinical Epidemiology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, PR China
| | - Yong Zhou
- Fujian Provincial Centers for Disease Control and Prevention, Fuzhou, PR China
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Feiring B, Laake I, Molden T, Håberg SE, Nøkleby H, Seterelv SS, Magnus P, Trogstad L. Do selective immunisation against tuberculosis and hepatitis B reach the targeted populations? A nationwide register-based study evaluating the recommendations in the Norwegian Childhood Immunisation Programme. Vaccine 2016; 34:2015-20. [PMID: 26947498 DOI: 10.1016/j.vaccine.2016.02.060] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 02/18/2016] [Accepted: 02/22/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Selective immunisation is an alternative to universal vaccination if children at increased risk of disease can be identified. Within the Norwegian Childhood Immunisation Programme, BCG vaccine against tuberculosis and vaccine against hepatitis B virus (HBV) are offered only to children with parents from countries with high burden of the respective disease. We wanted to study whether this selective immunisation policy reaches the targeted groups. METHODS The study population was identified through the Norwegian Central Population Registry and consisted of all children born in Norway 2007-2010 and residing in Norway until their second birthday, in total 240,484 children. Information on vaccinations from the Norwegian Immunisation Registry, and on parental country of birth from Statistics Norway, was linked to the population registry by personal identifiers. The coverage of BCG and HBV vaccine was compared with the coverage of vaccines in the universal programme. RESULTS Among the study population, 16.1% and 15.9% belonged to the target groups for BCG and HBV vaccine, respectively. Among children in the BCG target group the BCG vaccine coverage was lower than the coverage of pertussis and measles vaccine (83.6% vs. 98.6% and 92.3%, respectively). Likewise, the HBV vaccine coverage was lower than the coverage of pertussis and measles vaccine in the HBV target group (90.0% vs. 98.6% and 92.3%, respectively). The coverage of the targeted vaccines was highest among children with parents from South Asia and Sub-Saharan Africa. The coverage of vaccines in the universal programme was similar in targeted and non-targeted groups. CONCLUSIONS Children targeted by selective vaccination had lower coverage of the target vaccines than of vaccines in the universal programme, indicating that selective vaccination is challenging. Improved routines for identifying eligible children and delivering the target vaccines are needed. Universal vaccination of all children with these vaccines could be considered.
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Affiliation(s)
- Berit Feiring
- Norwegian Institute of Public Health, PO Box 4404 Nydalen, 0403 Oslo, Norway.
| | - Ida Laake
- Norwegian Institute of Public Health, PO Box 4404 Nydalen, 0403 Oslo, Norway.
| | - Tor Molden
- Norwegian Institute of Public Health, PO Box 4404 Nydalen, 0403 Oslo, Norway.
| | - Siri E Håberg
- Norwegian Institute of Public Health, PO Box 4404 Nydalen, 0403 Oslo, Norway.
| | - Hanne Nøkleby
- Norwegian Institute of Public Health, PO Box 4404 Nydalen, 0403 Oslo, Norway.
| | | | - Per Magnus
- Norwegian Institute of Public Health, PO Box 4404 Nydalen, 0403 Oslo, Norway.
| | - Lill Trogstad
- Norwegian Institute of Public Health, PO Box 4404 Nydalen, 0403 Oslo, Norway.
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Veldwijk J, van der Heide I, Rademakers J, Schuit AJ, de Wit GA, Uiters E, Lambooij MS. Preferences for Vaccination. Med Decis Making 2015; 35:948-58. [DOI: 10.1177/0272989x15597225] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 06/05/2015] [Indexed: 11/17/2022]
Abstract
Purpose. The purpose of this study is to examine to what extent health literacy is associated with parental preferences concerning childhood vaccination. Methods. A cross-sectional study was conducted among 467 Dutch parents of newborns aged 6 weeks (response rate of 37%). A self-reported questionnaire was used to measure health literacy by means of Chew’s Set of Brief Screening Questions, as well as parental preferences for rotavirus vaccination by means of a discrete choice experiment. Five rotavirus-related characteristics were included (i.e., vaccine effectiveness, frequency of severe side effects, location of vaccination, protection duration, and out-of-pocket costs). Panel latent class models were conducted, and health literacy and educational level were added to the class probability model to determine the association between health literacy and study outcomes. Results. Lower educated and lower health literate respondents considered protection duration to be more important and vaccine effectiveness and frequency of severe side effects to be less important compared with higher educated and higher health literate respondents. While all respondents were willing to vaccinate against rotavirus when the vaccine was offered as part of the National Immunization Program, only lower educated and lower health literate parents were willing to vaccinate when the vaccine was offered on the free market. Conclusion: Health literacy is associated with parents’ preferences for rotavirus vaccination. Whether differences in vaccination decisions are actually due to varying preferences or might be better explained by varying levels of understanding should be further investigated. To contribute to more accurate interpretation of study results, it may be advisable that researchers measure and report health literacy when they study vaccination decision behavior.
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Affiliation(s)
- Jorien Veldwijk
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands (JV, IH, AJS, GAW, EU, MSL)
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands (JV, GAW)
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands (IH, JR)
- Department of Health Sciences and EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, the Netherlands (AJS)
| | - Iris van der Heide
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands (JV, IH, AJS, GAW, EU, MSL)
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands (JV, GAW)
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands (IH, JR)
- Department of Health Sciences and EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, the Netherlands (AJS)
| | - Jany Rademakers
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands (JV, IH, AJS, GAW, EU, MSL)
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands (JV, GAW)
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands (IH, JR)
- Department of Health Sciences and EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, the Netherlands (AJS)
| | - A. Jantine Schuit
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands (JV, IH, AJS, GAW, EU, MSL)
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands (JV, GAW)
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands (IH, JR)
- Department of Health Sciences and EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, the Netherlands (AJS)
| | - G. Ardine de Wit
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands (JV, IH, AJS, GAW, EU, MSL)
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands (JV, GAW)
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands (IH, JR)
- Department of Health Sciences and EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, the Netherlands (AJS)
| | - Ellen Uiters
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands (JV, IH, AJS, GAW, EU, MSL)
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands (JV, GAW)
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands (IH, JR)
- Department of Health Sciences and EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, the Netherlands (AJS)
| | - Mattijs S. Lambooij
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands (JV, IH, AJS, GAW, EU, MSL)
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands (JV, GAW)
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands (IH, JR)
- Department of Health Sciences and EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, the Netherlands (AJS)
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Lambooij MS, Harmsen IA, Veldwijk J, de Melker H, Mollema L, van Weert YWM, de Wit GA. Consistency between stated and revealed preferences: a discrete choice experiment and a behavioural experiment on vaccination behaviour compared. BMC Med Res Methodol 2015; 15:19. [PMID: 25887890 PMCID: PMC4359569 DOI: 10.1186/s12874-015-0010-5] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Accepted: 02/20/2015] [Indexed: 11/13/2022] Open
Abstract
Background Discrete Choice Experiments (DCEs) are increasingly used in studies in healthcare research but there is still little empirical evidence for the predictive value of these hypothetical situations in similar real life circumstances. The aim of this paper is to compare the stated preferences in a DCE and the accompanying questionnaire with the revealed preferences of young parents who have to decide whether to vaccinate their new born child against hepatitis B. Methods A DCE asking parents to decide in which scenario they would be more inclined to vaccinate their child against hepatitis B. The stated preference was estimated by comparing the per respondent utility of the most realistic scenario in which parents could choose to vaccinate their child against hepatitis B, with the utility of the opt-out, based on the mixed logit model from the DCE. This stated preference was compared with the actual behaviour of the parents concerning the vaccination of their new born child. Results In 80% of the respondents the stated and revealed preferences corresponded. The positive predictive value is 85% but the negative predictive value is 26%. Conclusions The predictive value of the DCE in this study is satisfactory for predicting the positive choice but not for predicting the negative choice. However, the behaviour in this study is exceptional in the sense that most people chose to vaccinate. Future studies should focus on behaviours with a larger variance in the population. Electronic supplementary material The online version of this article (doi:10.1186/s12874-015-0010-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mattijs S Lambooij
- National Institute of Health and the Environment, Centre for Prevention and Health Services Research, P.O. Box 1 3720, Bilthoven, BA, The Netherlands.
| | - Irene A Harmsen
- National Institute of Health and the Environment, Centre for Infectious Disease Control, P.O. Box 1 3720, Bilthoven, BA, The Netherlands. .,Maastricht University, Work & Social Psychology, P.O. Box 616, Maastricht, MD, 6200, The Netherlands.
| | - Jorien Veldwijk
- National Institute of Health and the Environment, Centre for Prevention and Health Services Research, P.O. Box 1 3720, Bilthoven, BA, The Netherlands. .,Julius Centre for Health Sciences and Primary Care University Medical Center Utrecht, P.O. Box 85500, Utrecht, GA, 3508, The Netherlands.
| | - Hester de Melker
- National Institute of Health and the Environment, Centre for Infectious Disease Control, P.O. Box 1 3720, Bilthoven, BA, The Netherlands.
| | - Liesbeth Mollema
- National Institute of Health and the Environment, Centre for Infectious Disease Control, P.O. Box 1 3720, Bilthoven, BA, The Netherlands.
| | - Yolanda W M van Weert
- National Institute of Health and the Environment, Centre for Infectious Disease Control, P.O. Box 1 3720, Bilthoven, BA, The Netherlands.
| | - G Ardine de Wit
- National Institute of Health and the Environment, Centre for Prevention and Health Services Research, P.O. Box 1 3720, Bilthoven, BA, The Netherlands. .,Julius Centre for Health Sciences and Primary Care University Medical Center Utrecht, P.O. Box 85500, Utrecht, GA, 3508, The Netherlands.
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van Keulen HM, Otten W, Ruiter RAC, Fekkes M, van Steenbergen J, Dusseldorp E, Paulussen TWGM. Determinants of HPV vaccination intentions among Dutch girls and their mothers: a cross-sectional study. BMC Public Health 2013; 13:111. [PMID: 23388344 PMCID: PMC3570492 DOI: 10.1186/1471-2458-13-111] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Accepted: 01/24/2013] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The Dutch government recently added universal Human Papilloma Virus (HPV) vaccination for 12-year-old girls to the existing national immunization program. The participation rate for the initial catch-up campaign for girls aged 13 to 16 years in 2009 was lower (47%) than expected (70%). To inform future HPV information campaigns, this paper examines the social and psychological determinants of the HPV vaccination intentions of girls aged 13 to 16 years and their mothers who were targeted by the Dutch catch-up campaign of 2009. METHODS A random sample of girls and their mothers was chosen from the Dutch vaccination register and received a letter inviting them to participate (n = 5,998 mothers and daughters). In addition, a random sample was recruited via an online panel by a marketing research company (n = 650 mothers; n = 350 daughters). Both groups were asked to complete a web-based questionnaire with questions on social demographic characteristics, social-psychological factors and HPV vaccination intention. Backward linear regression analyses were conducted to examine which social-psychological factors were most dominantly associated with vaccination intention. RESULTS Data from 952 mothers (14%) and 642 daughters (10%) were available for the intended analyses. The contribution of social demographic variables to the explained variance of HPV vaccination intention was small but significant for mothers (ΔR² = .01; p = .007), but not significant for daughters (ΔR² = .02; p = .17) after controlling for HPV vaccination uptake and the sample. In addition, social-psychological determinants largely contributed to the explained variance of HPV vaccination intention of mothers (ΔR² = .35; p < .001) and daughters (ΔR² = .34; p < .001). Attitudes, beliefs, subjective norms and habit strength were significantly associated with participants' HPV vaccination intentions. CONCLUSIONS Because of the large contribution of social-psychological variables to the explained variance of HPV vaccination intentions among the mothers and daughters, future communication strategies targeting HPV vaccination uptake should address attitudes, beliefs, subjective norms and habit strength. There is a need for longitudinal research to confirm the causality of the association between these determinants and HPV vaccination behavior indicated by this study.
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Affiliation(s)
- Hilde M van Keulen
- TNO (Netherlands Organization for Applied Scientific Research), Expertise Center Life Style, PO Box 2215, Leiden, 2301 CE, the Netherlands
| | - Wilma Otten
- TNO (Netherlands Organization for Applied Scientific Research), Expertise Center Life Style, PO Box 2215, Leiden, 2301 CE, the Netherlands
| | - Robert AC Ruiter
- Department of Work and Social Psychology, Maastricht University, PO Box 616, Maastricht, 6200 MD, the Netherlands
| | - Minne Fekkes
- TNO (Netherlands Organization for Applied Scientific Research), Expertise Center Life Style, PO Box 2215, Leiden, 2301 CE, the Netherlands
| | - Jim van Steenbergen
- National Institute for Public Health and the Environment (RIVM), Center for Infectious Disease Control, PO Box 1, Bilthoven, 3720 BA, the Netherlands
- Leiden University Medical Center, Center for Infectious Diseases, PO Box 9600, Leiden, 2300 RC, the Netherlands
| | - Elise Dusseldorp
- TNO (Netherlands Organization for Applied Scientific Research), Expertise Center Life Style, PO Box 2215, Leiden, 2301 CE, the Netherlands
| | - Theo WGM Paulussen
- TNO (Netherlands Organization for Applied Scientific Research), Expertise Center Life Style, PO Box 2215, Leiden, 2301 CE, the Netherlands
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10
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Psychosocial determinants of parents’ intention to vaccinate their newborn child against hepatitis B. Vaccine 2012; 30:4771-7. [DOI: 10.1016/j.vaccine.2012.05.034] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Revised: 05/02/2012] [Accepted: 05/15/2012] [Indexed: 11/22/2022]
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11
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Mollema L, Wijers N, Hahné SJM, van der Klis FRM, Boshuizen HC, de Melker HE. Participation in and attitude towards the national immunization program in the Netherlands: data from population-based questionnaires. BMC Public Health 2012; 12:57. [PMID: 22264347 PMCID: PMC3298495 DOI: 10.1186/1471-2458-12-57] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2010] [Accepted: 01/20/2012] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Knowledge about the determinants of participation and attitude towards the National Immunisation Program (NIP) may be helpful in tailoring information campaigns for this program. Our aim was to determine which factors were associated with nonparticipation in the NIP and which ones were associated with parents' intention to accept remaining vaccinations. Further, we analyzed possible changes in opinion on vaccination over a 10 year period. METHODS We used questionnaire data from two independent, population-based, cross-sectional surveys performed in 1995-96 and 2006-07. For the 2006-07 survey, logistic regression modelling was used to evaluate what factors were associated with nonparticipation and with parents' intention to accept remaining vaccinations. We used multivariate multinomial logistic regression modelling to compare the results between the two surveys. RESULTS Ninety-five percent of parents reported that they or their child (had) participated in the NIP. Similarly, 95% reported they intended to accept remaining vaccinations. Ethnicity, religion, income, educational level and anthroposophic beliefs were important determinants of nonparticipation in the NIP. Parental concerns that played a role in whether or not they would accept remaining vaccinations included safety of vaccinations, maximum number of injections, whether vaccinations protect the health of one's child and whether vaccinating healthy children is necessary. Although about 90% reported their opinion towards vaccination had not changed, a larger proportion of participants reported to be less inclined to accept vaccination in 2006-07 than in 1995-96. CONCLUSION Most participants had a positive attitude towards vaccination, although some had doubts. Groups with a lower income or educational level or of non-Western descent participated less in the NIP than those with a high income or educational level or indigenous Dutch and have been less well identified previously. Particular attention ought to be given to these groups as they contribute in large measure to the rate of nonparticipation in the NIP, i.e., to a greater extent than well-known vaccine refusers such as specific religious groups and anthroposophics. Our finding that the proportion of the population inclined to accept vaccinations is smaller than it was 10 years ago highlights the need to increase knowledge about attitudes and beliefs regarding the NIP.
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Affiliation(s)
- Liesbeth Mollema
- Centre for Infectious Disease Control Netherlands, RIVM, Bilthoven, The Netherlands
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control Netherlands, Epidemiology and Surveillance Unit, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands
| | - Nancy Wijers
- Centre for Infectious Disease Control Netherlands, RIVM, Bilthoven, The Netherlands
- Department of Earth and Life Science, VU University Amsterdam, Amsterdam, The Netherlands
| | - Susan JM Hahné
- Centre for Infectious Disease Control Netherlands, RIVM, Bilthoven, The Netherlands
| | | | - Hendriek C Boshuizen
- ICT/Expertise Centre for Methodology and Information Service, RIVM, Bilthoven, The Netherlands
| | - Hester E de Melker
- Centre for Infectious Disease Control Netherlands, RIVM, Bilthoven, The Netherlands
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12
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Houweling H, Spaendonck MCV, Paulussen T, Verweij M, Ruitenberg EJ. Preparing for the next public debate: universal vaccination against hepatitis B. Vaccine 2011; 29:8960-4. [PMID: 21945254 DOI: 10.1016/j.vaccine.2011.09.042] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2011] [Revised: 09/01/2011] [Accepted: 09/11/2011] [Indexed: 11/18/2022]
Abstract
WHO have long called for universal vaccination against hepatitis B worldwide. However, in north-western Europe low incidence of the disease has fueled debate whether targeted or universal vaccination strategies are the way to go for. Careful assessment has made it clear that the extensive targeted hepatitis B vaccination programmes in the Netherlands nevertheless fail to reach a significant part of the risk groups and have not succeeded in eliminating the disease. Modelling suggests that the public health benefits obtained through targeted programmes could be augmented considerably by universal vaccination. Therefore, the Minister of Health of the Netherlands has decided to implement universal vaccination by October 2011. We illustrate the case of the Netherlands and explore lessons, which can be learnt from the vaccination programmes against HPV and influenza A/H1N1 and how to prepare for a potential public debate that might arise when implementing universal vaccination against hepatitis B.
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Affiliation(s)
- Hans Houweling
- Health Council of the Netherlands, The Hague, The Netherlands.
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Houweling H, Wittevrongel CFW, Verweij M, Ruitenberg EJ. Public vaccination programmes against hepatitis B in The Netherlands: assessing whether a targeted or a universal approach is appropriate. Vaccine 2010; 28:7723-30. [PMID: 20933042 DOI: 10.1016/j.vaccine.2010.09.068] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2010] [Revised: 09/15/2010] [Accepted: 09/21/2010] [Indexed: 10/19/2022]
Abstract
To date, the policy to control hepatitis B in the Netherlands is to vaccinate specific risk groups, rather than all children. Low incidence of the disease has fueled debate whether such a targeted vaccination strategy or rather a universal strategy, as recommended by the World Health Organization, is appropriate. The standard framework for assessing whether a particular vaccination should be included in a public programme, as recently proposed by the Health Council of the Netherlands (HCN), was applied to the various options for hepatitis B vaccination. This framework includes seven selection criteria, grouped under five thematic headings: seriousness and extent of the disease burden, effectiveness and safety of the vaccination, acceptability of the vaccination, efficiency of the vaccination, and priority of the vaccination. From about 1990 the disease burden has stayed more or less the same over time and careful assessment has made it clear that the targeted approach has failed to reach a significant part of the risk groups. Models suggest that the public health benefits obtained through targeted programmes could be augmented considerably by universal vaccination. Based on the assessment that universal vaccination means better protection for high-risk groups as well as the whole population, the HCN calls for universal immunisation, even though hepatitis B to a large extent is limited to specific high-risk groups. Should the Netherlands adopt universal vaccination, several immunisation programmes targeted to high-risk groups will, however, remain of crucial importance for years to come.
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Affiliation(s)
- Hans Houweling
- Health Council of the Netherlands, The Hague, The Netherlands.
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