Negative attitude and low intention to vaccinate universally against varicella among public health professionals and parents in the Netherlands: two internet surveys

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Abstract

Background

Prior to introduction of universal varicella vaccination, it is crucial to gain insight into the willingness to vaccinate among the population. This is because suboptimal national vaccination coverage might increase the age of infection in children, which will lead to higher complication rates. We studied the attitude and intention to vaccinate against varicella among Dutch public health professionals who execute the National Immunisation Programme (NIP), and parents.

Methods

Medical doctors and nurses of regional public health services (RPHS) and child health clinics (CHC), and a random sample of parents received an internet survey on varicella vaccination. Separate logistic regression models were used to identify determinants for a positive attitude (professionals) or a positive intention (parents) to vaccinate against varicella within the NIP (free of charge).

Results

The questionnaire was completed by 181 RPHS professionals (67 %), 260 CHC professionals (46 %), and 491 parents (33 %). Of professionals, 21 % had a positive attitude towards universal varicella vaccination, while 72 % preferred to limit vaccination to high-risk groups only. Of parents, 28 % had a positive intention to vaccinate their child against varicella within the NIP. The strongest determinant for a positive attitude or intention to vaccinate against varicella among professionals and parents was the belief that varicella is a disease serious enough to vaccinate against.

Conclusions

We showed that a majority of the Dutch public health professionals and parents in this study have a negative attitude or low intention to vaccinate universally against varicella, as a result of the perceived low severity of the disease. Most participating professionals support selective vaccination to prevent varicella among high-risk groups.

Electronic supplementary material

The online version of this article (doi:10.1186/s12879-016-1442-1) contains supplementary material, which is available to authorized users.

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Most cited references 23

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Controlling the False Discovery Rate: A Practical and Powerful Approach to Multiple Testing

Yoav Benjamini, Yosef Hochberg (1995)

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THE NATURE OF HERPES ZOSTER: A LONG-TERM STUDY AND A NEW HYPOTHESIS.

Paul R Hope (1964)

Dr Hope-Simpson presents a study of all cases of herpes zoster occurring in his general practice during a sixteen-year period. The rate was 3.4 per thousand per annum, rising with age, and the distribution of lesions reflected that of the varicella rash.It was found that severity increased with age, but that the condition did not occur in epidemics, and that there was no characteristic seasonal variation. A low prevalence of varicella was usually associated with a high incidence of zoster.Dr Hope-Simpson suggests that herpes zoster is a spontaneous manifestation of varicella infection. Following the primary infection (chickenpox), virus becomes latent in the sensory ganglia, where it can be reactivated from time to time (herpes zoster). Herpes zoster then represents an adaptation enabling varicella virus to survive for long periods, even without a continuous supply of persons susceptible to chickenpox.

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Association between health care providers' influence on parents who have concerns about vaccine safety and vaccination coverage.

L Pickering, Deborah Gust, J. Smith … (2006)

Parents who have concerns about vaccine safety may be reluctant to have their children vaccinated. The purpose of this study was to explore how vaccination coverage among children 19 to 35 months of age is associated with health care providers' influence on parents' decision to vaccinate their children, and with parents' beliefs about vaccine safety. Parents of 7695 children 19 to 35 months of age sampled by the National Immunization Survey were administered the National Immunization Survey Parental Knowledge Module between the third quarter of 2001 and the fourth quarter of 2002. Health care providers were defined as a physician, nurse, or any other type of health care professional. Parents provided responses that summarized the degree to which they believed vaccines were safe, and the influence providers had on their decisions to vaccinate their children. Children were determined to be up-to-date if their vaccination providers reported administering > or = 4 doses of diphtheria and tetanus toxoids and acellular pertussis vaccine, > or = 3 doses of polio vaccine, > or = 1 dose of measles-mumps-rubella vaccine, > or = 3 doses of Haemophilus influenzae type b vaccine, and > or = 3 doses of hepatitis B vaccine. Of all of the parents, 5.7% thought that vaccines were not safe, and 21.5% said that their decision to vaccinate their children was not influenced by a health care provider. Compared with parents who responded that providers were not influential in their decision to vaccinate their children, parents who responded that providers were influential were twice as likely to respond that vaccines were safe for children. Among children whose parents believed that vaccines were not safe, those whose parents' decision to vaccinate was influenced by a health care provider had an estimated vaccination coverage rate that was significantly higher than the estimated coverage rate among children whose parents' decision was not influenced by a health care provider (74.4% vs 50.3%; estimated difference: 24.1%). Health care providers have a positive influence on parents to vaccinate their children, including parents who believe that vaccinations are unsafe. Physicians, nurses, and other health care professionals should increase their efforts to build honest and respectful relationships with parents, especially when parents express concerns about vaccine safety or have misconceptions about the benefits and risks of vaccinations.

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Author and article information

Contributors

Alies van Lier: +31 (0) 30 274 33 67 , alies.van.lier@rivm.nl

Alma Tostmann: alma.tostmann@radboudumc.nl

Irene A. Harmsen: iharmsen@ggd.amsterdam.nl

Hester E. de Melker: hester.de.melker@rivm.nl

Jeannine L. A. Hautvast: jeannine.hautvast@radboudumc.nl

Wilhelmina L. M. Ruijs: helma.ruijs@rivm.nl

Journal

Journal ID (nlm-ta): BMC Infect Dis

Journal ID (iso-abbrev): BMC Infect. Dis

Title: BMC Infectious Diseases

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2334

Publication date (Electronic): 15 March 2016

Publication date PMC-release: 15 March 2016

Publication date Collection: 2016

Volume: 16

Electronic Location Identifier: 127

Affiliations

[ ]Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1 (internal P.O. Box 75), 3720 BA Bilthoven, The Netherlands

[ ]Regional Public Health Service ‘GGD Gelderland-Zuid’, P.O. Box 1120, 6501 BC Nijmegen, The Netherlands

[ ]Department of Work & Social Psychology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands

[ ]Academic Collaborative Centre AMPHI, Department of Primary and Community Care, Radboud university medical center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands

Article

Publisher ID: 1442

DOI: 10.1186/s12879-016-1442-1

PMC ID: 4793755

PubMed ID: 26979822

SO-VID: 829cd685-7e6f-420a-b33d-bc9b30947322

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 28 August 2015

Date accepted : 22 February 2016

Custom metadata

ScienceOpen disciplines: Infectious disease & Microbiology

Keywords: varicella zoster virus,varicella,chickenpox,vaccination,epidemiology,intention

Data availability:

ScienceOpen disciplines: Infectious disease & Microbiology

Keywords: varicella zoster virus, varicella, chickenpox, vaccination, epidemiology, intention

Negative attitude and low intention to vaccinate universally against varicella among public health professionals and parents in the Netherlands: two internet surveys

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JAMA Network: Coronavirus

Most cited references 23

Controlling the False Discovery Rate: A Practical and Powerful Approach to Multiple Testing

THE NATURE OF HERPES ZOSTER: A LONG-TERM STUDY AND A NEW HYPOTHESIS.

Association between health care providers' influence on parents who have concerns about vaccine safety and vaccination coverage.

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