Determining Factors for Pertussis Vaccination Policy: A Study in Five EU Countries
2. Materials and Methods
2.1. Selection of Countries
2.2. Methods for Interviews
2.3. Ethical Approval
3.1. Inter-Coder Agreement
3.2. Determining Factors of Pertussis Vaccination Policy
3.3.1. Type of Vaccine
3.3.2. Immunization Schedule
“That was in the 80s, we looked at the pertussis trial and we found that the immune response is the best if you give the vaccine at 2-month intervals instead of 1-month intervals. And it’s better to start at the age of 3 month compared to 2 month…”(Sweden expert)
“And in France, we decided to adopt such a schedule but we did not want to start at 3 month because we knew that if you start one month later, you will have more pertussis cases. So we chose to start at 2 months…”(France expert)
“The advantage of having an accelerated course is that you’re not only offering protection at an earliest infant age but also we’ve found that you’re more likely to achieve higher uptake, when you’re offering it at an earlier age.”(UK expert)
3.3.3. Maternal Vaccination
“…we have no, well, very few infant deaths. And that is the major marker for introducing the vaccination in pregnancy, of course. We had an epidemic in 2016. And that’s prompted, the Health Authority to think about renewing the vaccination strategies. And vaccination in pregnancy was one of them although we haven’t implemented it.”(Denmark expert)
“So now it has changed in favor of maternal vaccination. Pertussis is not a big problem for the moment, but in case there will be an increase of infants infectedwith pertussis, I think there will be a change in the program towards this recommendation.”(Sweden expert)
“We experienced a very significant increase in overall rate of disease across the entire population, but particularly in those very young babies. And we had an increase in pertussis deaths, we had 14 deaths from pertussis in 2012. So the introduction of the maternal program was very much introduced and prompted by the increased rate of disease. We’ve done it as an emergency program…”(UK expert)
“Well, it’s typical that one reason why we didn’t jump at that strategy is that we have the question mark of what will be the acceptance rate of such a strategy.”(France expert)
“…we have an investigation in the public health agency a couple of years ago. At that time, there was some hesitancy. They were looking for more data. There’s some kind of blunting or immune response in the children.”(Sweden expert)
3.3.4. Other Important Discourse: Policy Implementation
“And something that might fuel distrust towards the expert professionals, in Poland at least, is the strength and unquestionability of the consensus already existing among professionals.”(Poland expert)
“….that doesn’t mean they were against vaccines, it just means that they were against mandatory vaccination… is it going to push part of the people who are hesitant towards a more radical stance, you know, going to very private schools, where they look the other way and don’t really check whether the children are vaccinated? And the issue is whether it’s going to create small pockets of severely under-vaccinated people…”(France expert)
“I can’t see a reason for introducing a compulsory element to this because it’s a program that’s already very well delivered and very well received. So I can’t see a role for mandating in our population at this time. And I doubt it would improve uptake, and it could be counterproductive.”(UK expert)
“…but if the results speak for themselves and the health authorities recommend something, people tend to do that. And I believe, and I know I’m not alone in believing that, if we were to make mandatory vaccination, it would actually spark this hesitancy, it would spark distrust. And I think it would be detrimental for our program to do that.”(Denmark expert)
Conflicts of Interest
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|(1) Have work experience of 3 years or above in the field related to vaccination policy or pertussis research in the country;|
|(2) Have professional knowledge on pertussis vaccine or vaccination policy in the country;|
|(3) Are able to communicate effectively in English;|
|(4) Are willing to participate and have given informed consent.|
|(1) Vaccine manufacturers and their employees;|
|(2) Withdrawn consent during or after interview.|
|Demographic Characteristics||Information from Participants a||n|
|Professional background||Social & Political Science||4|
|Epidemiology & Medicine||7|
|Microbiology & Immunology||4|
|Involvement in Policy Process||Yes||9|
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Wong, A.; Opinel, A.; Combes, S.J.-B.; Toubiana, J.; Brisse, S. Determining Factors for Pertussis Vaccination Policy: A Study in Five EU Countries. Vaccines 2020, 8, 46. https://doi.org/10.3390/vaccines8010046
Wong A, Opinel A, Combes SJ-B, Toubiana J, Brisse S. Determining Factors for Pertussis Vaccination Policy: A Study in Five EU Countries. Vaccines. 2020; 8(1):46. https://doi.org/10.3390/vaccines8010046Chicago/Turabian Style
Wong, Anabelle, Annick Opinel, Simon Jean-Baptiste Combes, Julie Toubiana, and Sylvain Brisse. 2020. "Determining Factors for Pertussis Vaccination Policy: A Study in Five EU Countries" Vaccines 8, no. 1: 46. https://doi.org/10.3390/vaccines8010046