Participation in and attitude towards the national immunization program in the Netherlands: data from population-based questionnaires

Abstract

BackgroundKnowledge 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.MethodsWe 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.ResultsNinety-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.ConclusionMost 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.

The benefit of the doubt or doubts over benefits? A systematic literature review of perceived risks of vaccines in European populations

“…Eleven articles studied concerns about childhood vaccination in general [143][144][145][146][147][148][149][150][151][152][153][154]. The most common concerns were about adverse reactions [144][145][146][147][148][150][151][152][153][154].…”

“…The most common concerns were about adverse reactions [144][145][146][147][148][150][151][152][153][154]. Other studies reported that participants believed that vaccine preventable diseases are not dangerous [147,148,150] but instead are beneficial for child development [149,150].…”

“…Some also believed that risks of vaccination outweigh benefits [147,150,154]. Studies found that interviewed participants reported inadequate information and evidence [143,144,147,153] and disagreements between experts on vaccine safety [144].There were beliefs that vaccines do not work or have a short duration of protection [143,146,150,154], supporting the perception that vaccines are not useful [146,153,154].…”

Parental attitudes and decision-making regarding MMR vaccination in an anthroposophic community in Sweden – A qualitative study

“…An anthroposophic lifestyle often includes a biodynamic diet, wool fabric for clothing and restrictive use of antibiotics and antipyretics. Anthroposophic followers are hesitant to vaccinate due to beliefs that measles infections strengthens children's development [27,[35][36][37]. The philosophy is the basis for anthroposophic medicine and the pedagogy in Waldorf schools.…”

Assessment of vaccine candidates for persons aged 50 and older: a review

“…Mortality rates were obtained from Statistics Netherlands, which registers mortality data from death certificates on a statutory basis. Seroprevalence data to estimate prevalences of varicella zoster, pertussis and hepatitis A were available from two cross-sectional, population-based serosurveillance studies carried out in 1995–1996 and 2006–2007 among persons aged 0 to 79 years [14,15]. The international literature was searched for additional information on the four domains of the evaluation model for each of the infectious diseases in the study population.…”