Decision-making on maternal pertussis vaccination among women in a vaccine-hesitant religious group: Stages and needs

Abstract

Introduction As of December 2019, pregnant women in the Netherlands are offered pertussis vaccination to protect their newborn infant against pertussis infection. However, the manner in which pregnant women decide about this maternal pertussis vaccination is largely unknown. The aim of this study is to gain insight into the decision-making process regarding maternal pertussis vaccination, and to explore the related needs among the vaccine-hesitant subgroup of orthodox Protestant women. Methods Charmaz’s grounded theory approach was used to develop a decision-making framework. To construct this framework we used an explorative multimethod approach in which in-depth interviews and online focus groups were supplemented by a literature search and research group meetings. This study was carried out in a hypothetical situation since the maternal pertussis vaccination had yet to be implemented in the Dutch immunisation programme at the time of the study. Results Twenty-five orthodox Protestant women participated in an interview, an online focus group, or in both. The findings of this study resulted in a decision-making framework that included three stages of decision-making; an Orientation stage, a value-based Deliberation stage, and Final decision stage. The Orientation stage included the needs for decision-making categorised into Information needs and Conversation needs. Women indicated that -if they were to receive sufficient time for Orientation and Deliberation- they would be able to reach the stage of Final decision. Conclusion The decision-making framework resulting from our findings can be used by health care professionals to provide women with information and consultation in the decision-making process. Future studies should investigate whether the stages of and needs for decision-making can be found across other vaccine-hesitant subgroups and vaccinations.

Decision-making on COVID-19 vaccination: A qualitative study among health care and social workers caring for vulnerable individuals

“…Our findings add to this body of literature by revealing informational (the feeling of being overwhelmed by the information regarding the COVID-19 vaccination), relational (the depersonalization of both the vaccinator and the vaccinated), moral (the particularly strong moral significance attached to the COVID-19 vaccination decision), and emotional (the fear of discrimination as a result of the vaccination decision) constraints to the COVID-19 vaccination decision-making process. First, while there is evidence that the vaccination decision-making process is shaped by one's information seeking behavior ( de Munter et al, 2020 ), our results indicate that excessive information constitutes a challenge to the decision. This finding is not surprising.…”

Considerable doubt about rubella screening and vaccination among unvaccinated orthodox protestant women: a mixed-methods study

“…The second driver is also likely to apply to orthodox Protestants, although it is likely that rubella is a less discussed topic among friends and family members since the last outbreak occurred more than 15 years ago. Moreover, in line with the third driver, orthodox Protestant women's negative attitude can be partially explained by their indecisiveness or negative intention towards vaccination based on both religious and health-related aspects [18,19], supplemented by their perception that they had been infected with rubella as a child.…”

“…In a previously conducted study on maternal pertussis vaccination, orthodox Protestant women reported gathering information as an essential need to make a well-considered vaccination decision [18]. In addition to receiving information, women in the maternal pertussis vaccination study wanted sufficient time to search for information themselves, to converse with others about the vaccination, and to deliberate the values they consider to be important concerning the vaccination [18]. It can be assumed that unvaccinated women, when offered rubella screening or vaccination, also need both information and sufficient time to come to a deliberate, informed decision.…”

“…This indicates a higher susceptibility among the upcoming generation of orthodox Protestant pregnant women. As known from previous studies among orthodox Protestant women, most women want to make an informed and deliberate vaccination decision, with both religious and health-related aspects influencing their vaccination decision [18,19]. However, more knowledge is needed on orthodox Protestant women's rubella screening and vaccination intention and its underlying mechanisms.…”

Identifying Strategies to Boost COVID-19 Vaccine Acceptance in the United States

“…Certain racial and ethnic groups, including Hispanic/Latinx and African American populations, have disproportionately higher prevalence of vaccine hesitancy (Kessels et al, 2012;Rutten et al, 2021). Similarly, social and religious beliefs, values, or norms can directly lower the rate of vaccination among tight-knit communities (de Munter et al, 2020;Ferrer et al, 2014;Joshi, Chaudhari, and Chaudhari, 2020;WHO, 2021). For instance, some conservative religious groups have endorsed beliefs that vaccination against human papillomavirus (HPV) leads to increased engagement in sexual activity (Fisher et al, 2013).…”