https://orcid.org/0000-0003-0665-5385
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ABSTRACT
Pertussis vaccination of parents and household contacts (‘cocooning’) to protect newborn infants is an established strategy in many countries, although uptake may be low. Many aspects may influence such decision-making. We conducted a cross-sectional survey (NCT01890447) of households and other close contacts of newborns aged ≤6 months (or of expectant mothers in their last trimester) in Spain and Italy, using an adaptive discrete-choice experiment questionnaire. Aims were to assess the relative importance of attributes influencing vaccine adoption, and to estimate variation in vaccine adoption rates and the impact of cost on vaccination rates. Six hundred and fifteen participants (Spain, n = 313; Italy, n = 302) completed the survey. Of 144 available questionnaire scenarios, the most frequently selected (14% of respondents in both countries) were infant protection by household vaccination at vaccination center, recommendation by family physician and health authorities, with information available on leaflets and websites. The attribute with highest median relative importance was ‘reduction in source of infection’ in Spain (23.1%) and ‘vaccination location’ in Italy (18.8%). Differences between other attributes were low in both countries, with media attributes showing low importance. Over 80% of respondents indicated a definite or probable response to vaccine adoption (at no-cost) with estimated probability of adoption of 89–98%; applying vaccine costs (25€ per person) would reduce the probability of uptake by 7–20% in definite/probable respondents. Awareness of these determinants is helpful in informing Health Authorities and healthcare practitioners implementing a cocooning strategy for those populations where maternal immunization is not a preferred option.
Acknowledgments
The authors would like to thank Business & Decision Life Sciences platform for editorial assistance and manuscript coordination, on behalf of GSK. Grégory Leroux coordinated manuscript development and editorial support. The authors also thank Iain O’Neill (freelance on behalf of GSK) for providing medical writing support. The authors would also like to thank Janet Reyes and Laura Cappellari (GSK, Clinical Operations) for their contribution to the study.
Authors contributions
EL, GG, EWdBG, PT, CA, WK and FM were involved in the design of the study. All authors but FM contributed to the collection or generation of the data. EL, MCM, FF, PT, GZ, CA, WK and FM analyzed and/or interpreted the study data. All authors participated in the development of this manuscript and in its critical review with important intellectual contributions. All authors had full access to the data and gave final approval before submission. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The work described was carried out in accordance with ICMJE recommendations for the conduct, reporting, editing and publication of scholarly work in medical journals. The corresponding author had final responsibility to submit for publication.
Disclosure of potential conflicts of interest
EL, WK and FM are employees of the GSK group of companies. EL and FM hold shares in the GSK group of companies. GG is a member of the Regional Commission on Vaccines (Emilia Romagna Region, Italy). GG declares that members of this Commission are asked to give advice on how to optimize immunizations in the region and do not have any decision-making role; the Commission has a technical and scientific role. GG reports personal fees for board membership from the GSK group of companies, Sanofi Pasteur MSD, Sanofi Pasteur Italy, Seqirus, PaxVax and Merck Sharp & Dohme; personal fees for consultancy from the GSK group of companies, Sanofi Pasteur MSD and Merck Sharp & Dohme; personal fees for lectures from the GSK group of companies, Sanofi Pasteur MSD, Seqirus, Merck Sharp & Dohme, Pfizer and Novartis; and grants for participation in clinical trials from the GSK group of companies and from Sanofi Pasteur MSD; outside the submitted work. EWdBG reports a grant received by the Department of Public Health, Erasmus MC – University Medical Centre Rotterdam from the GSK group of companies to support this study. MCM reports clinical trials fees from the GSK group of companies to her institution during the conduct of this study and having received grants from the GSK group of companies, Novartis, Sanofi Pasteur MSD and Pfizer outside the submitted work. MJFC reports grants from the GSK group of companies during the conduct of this study. FF reports non-financial support from the GSK group of companies during the conduct of this study and outside the submitted work as well as non-financial support from Merck Sharp & Dohme outside the submitted work. CA was an employee of the GSK group of companies at the time of the study design and first results. CA is now an employee of Takeda Pharmaceuticals. JLAZ, MTDHG, GF, PT and GZ report no conflict of interest.
Ethics
The study protocol was reviewed and approved by the ethical review board of each participating center. Written informed consent was obtained from each participant prior to participation. This study was registered prospectively with ClinicalTrials.gov (NCT01890447).
Supplementary material
Supplementary material for this article can be accessed here.
