Countering Vaccine Hesitancy among Pregnant Women in England: The Case of Boostrix-IPV
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Sample Characteristics
3.2. Main Effects of Message Framing
3.3. Determinants of Intention to Receive the Whooping Cough Vaccine
3.4. Determinants of Being Vaccinated against Whooping Cough
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Appendix A. Experimental Conditions
The Content for this Condition was Drawn and Adapted from an Online Blog, Published on www.parents.com [53]. |
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Warning |
You or your baby could catch whooping cough by being around someone who has this disease. Whooping cough spreads from person to person through the air. The Boostrix-IPV vaccine for pregnant women can prevent against whooping cough. Most babies whose pregnant mothers get their Boostrix-IPV vaccine will not get this disease. Many more children will get whooping cough if we stop vaccinating. Here is a true story that shows why vaccination is so important. “Last July 4, when I was about to give birth, I came down with a cough. Five days later, our beautiful and healthy daughter, Caroline, was born. When Caroline was around 2 weeks old, she started developing a dry cough, especially following feedings. I called my paediatrician; Caroline tested positive for whooping cough. The doctors immediately asked if anyone around her had been sick with a cough. My heart sunk. I told them that I had. I had passed it on to Caroline. I felt guilty, knowing this had been preventable. There is nothing doctors can do for these babies, except be there to support them with oxygen. We spent a week hoping for the worst to pass-it’s a long road. Whooping cough is sometimes called the ‘100-day cough’.” Thankfully, the baby recovered fully. “After the worst was over, we were told that Caroline’s case was considered mild. That sounded crazy to me. Watching her heart rate drop and her face turn blue was beyond terrifying.” Pregnant women should be vaccinated for whooping cough. This is a serious disease. Please take your time to read the description of whooping cough and carefully view the picture of a baby with whooping cough. |
Whooping cough |
Whooping cough is a highly infectious serious illness that causes uncontrolled, violent coughing fits. It can lead to weight loss, brain damage, pneumonia and some cases may result in death. *picture of baby with whooping cough shown here |
Please Take your Time to Read Some Information about Whooping Cough. |
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Pregnant women should be vaccinated for whooping cough. Boostrix-IPV, the vaccine for whooping cough is safe and effective. Because some pregnant women worry about causing harm to themselves or their baby, they may worry about the safety of the vaccine. Vaccine safety experts, including experts at the Medicines and Healthcare products Regulatory Agency (MHRA) agree that the whooping cough vaccine is not related to risks in pregnancy or pregnancy outcomes. Many scientific studies have found no link between vaccinating against whooping cough whilst pregnant and negative outcomes for the mother or baby. These studies include:
|
The Content for This Condition was Drawn from The Royal Society for the Protection of Birds [54]. |
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You are eligible to take part in this study! Please take your time to read the information below. Feeding birds in the garden is a popular activity–over half of adults in the UK feed birds in their garden. That’s a lot of extra help for the birds! It is a great way to bring the birds closer to you to admire their fascinating behaviour and wonderful colours. Feeding birds is also an ideal way to enthuse children about wildlife. |
What food is best for birds? |
Difference birds need different foods to sustain them. If you supply a variety of food you are more likely to attract many types of birds. Household scraps such as pastry, cooked rice and breadcrumbs are enjoyed by many garden birds. Fruit, especially bruised apples and pears, will be popular with thrushes and blackbirds. When you are buying bird food, try to get a good mix of peanuts, seeds and live food such as mealworms and waxworms. Then you should have something to offer all the birds. Good ready-made mixes should contain sunflower seeds, broken peanuts, and flaked maize and smaller seeds such as millet. |
Where is the best place to put a bird table in my garden? |
Bird tables should be placed where the birds are safe and will be able to feed undisturbed. Avoid putting them near fences or thick hedges, where cats can easily get to them. If there is a small bush nearby, birds can use this as a look-out point to make sure it is safe. And don’t forget to make sure it is visible from a window so you can enjoy watching the birds as they feed. |
Appendix B
TBC Constructs, Demographics questions and Background Information. |
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Perceived Behavioural Control |
For each of the below, please rate your response from “disagree strongly” to “agree strongly”, where (1 = disagree strongly; 2 = disagree moderately; 3 = disagree a little; 4 = neither disagree nor agree; 5 = agree a little; 6 = agree moderately; 7 = agree strongly) If I wanted to, I could attend an appointment to get vaccinated against whooping cough I feel confident in my ability to get vaccinated for whooping cough. There are barriers in the way of me receiving the whooping cough vaccine. |
Attitudes |
For each of the below, please rate your response from “disagree strongly” to “agree strongly”, where (1 = disagree strongly; 2 = disagree moderately; 3 = disagree a little; 4 = neither disagree nor agree; 5 = agree a little; 6 = agree moderately; 7 = agree strongly) Getting vaccinated for whooping cough will help protect my baby from whooping cough. If I get vaccinated for whooping cough, I can reduce my baby’s risk of whooping cough. Getting vaccinated for whooping cough will decrease my chances of getting whooping cough. We just want to make sure you are paying attention. Select ‘disagree a little’ from the options provided. |
Intentions |
For each of the below, please rate your response from “very unlikely” to “very likely”, where (1 = very unlikely; 2 = somewhat unlikely; 3 = a little unlikely; 4 = neither unlikely nor likely; 5 = a little likely; 6 = somewhat likely; 7 = very likely) |
During your pregnancy… |
How likely is it that you’ll consider getting the whooping cough vaccine? How likely is it that you’ll try to get the whooping cough vaccine? How likely is it that you’ll actually get the whooping cough vaccine? If a doctor offered you the whooping cough vaccine during your pregnancy, how likely is it that you would get vaccinated? |
Subjective norms |
For each of the below, please rate your response from “not at all” to “a great deal”, where (1 = not at all; 2 = a little; 3 = somewhat; 4 = a lot; 5 = a great deal) How much do your parents think you should receive the whooping cough vaccine? How much does your doctor think you should receive the whooping cough vaccine? Are you paying attention? Please select ’somewhat’ from the options provided if you are. How much does your best female friend think you should receive the whooping cough vaccine? In general, I want to do what my parents think I should do. In general, I want to do what my doctor thinks I should do. In general, I want to do what my best female friend thinks I should do. Finally, we have a couple of questions about you. Please select one answer. |
What is your ethnicity? |
White British Other White African Caribbean Other Black Indian Bengali Pakistani Other Asian Mixed/multiple ethnic groups Other ethnic group |
What is the highest level of education that you have? (Please select). If your UK qualification is not listed, select the closest option. If you have qualifications from outside the UK, select the closest option. |
No qualifications GCSE, CSE, O Grade, Standard Grade, Access 3 Cluster, Intermediate 1 or 2, Senior Certificate or equivalent A Level, AS Level, SCE Higher Grade, Higher, Advanced Higher, CSYS, Advanced Senior Certificate or equivalent Other post-school but pre-Higher Education qualifications not already mentioned (including foreign qualifications), HNC, HND, SVQ level 4 Degree, Postgraduate qualifications, Masters, PhD, SVQ level 5 or equivalent; Professional qualifications (for example, teaching, nursing, accountancy); Other Higher Education qualifications not already mentioned (including foreign qualifications) |
Are you employed? (Please select) |
Yes No |
What is your current relationship status? (Please select) |
Single In a partnership Married Divorced Widowed Separated |
How many weeks pregnant are you currently? |
____________ |
How many children do you have? This does not include your current pregnancy. |
________________ |
Before taking this survey, were you aware of the whooping cough vaccine available for pregnant women? |
Yes No |
Have you already received the whooping cough vaccine during your pregnancy? |
Yes No |
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Disease Risk (n = 97) | Myth Busting (n = 98) | Control Condition (n = 87) | |
---|---|---|---|
Age (years) | |||
18–24 | 14 | 6 | 11 |
25–34 | 63 | 65 | 51 |
35–44 | 20 | 27 | 25 |
Ethnicity | |||
White British | 80 | 82 | 70 |
Other White | 13 | 10 | 10 |
Non White | 4 | 6 | 7 |
Education level | |||
GCSE or below | 7 | 6 | 6 |
A Level or equivalent | 19 | 9 | 6 |
College qualification | 5 | 5 | 11 |
Degree or higher | 66 | 78 | 64 |
Employment status | |||
Employed | 74 | 84 | 71 |
Unemployed | 23 | 14 | 16 |
Relationship status | |||
Single | 5 | 3 | 4 |
In a partnership | 32 | 26 | 18 |
Married | 60 | 69 | 65 |
Previous children | |||
No | 53 | 65 | 60 |
Yes | 44 | 33 | 27 |
Gestational age (wks) | |||
16–24 | 29 | 40 | 27 |
25–34 | 41 | 32 | 39 |
35+ | 23 | 22 | 19 |
Vaccine awareness | |||
Yes | 94 | 96 | 84 |
No | 3 | 2 | 3 |
Received vaccine | |||
Yes | 59 | 55 | 45 |
No | 38 | 43 | 42 |
Items | Overall | Currently Vaccinated | Currently Unvaccinated |
---|---|---|---|
n (%) | n (%) | n (%) | |
Perceived behavioural control a | |||
If I wanted to, I could attend an appointment to get vaccinated against whooping cough. | 264 (93.6) | 158 (99.4) | 106 (86.2) |
I feel confident in my ability to get vaccinated for whooping cough. | 259 (91.8) | 159 (100) | 100 (81.3) |
There are (no) barriers in the way of me receiving the whooping cough vaccine. | 235 (83.3) | 142 (89.3) | 93 (75.6) |
Attitudes a | |||
Getting vaccinated for whooping cough will help protect my baby from whooping cough. | 245 (86.9) | 157 (98.7) | 88 (71.5) |
If I get vaccinated for whooping cough, I can reduce my baby’s risk of whooping cough. | 249 (88.3) | 158 (99.4) | 91 (74.0) |
Getting vaccinated for whooping cough will decrease my chances of getting whooping cough. | 216 (76.6) | 137 (86.2) | 79 (64.2) |
Subjective norms b | |||
How much do your parents think you should receive the whooping cough vaccine? | 156 (55.3) | 100 (62.9) | 56 (45.5) |
How much does your doctor think you should receive the whooping cough vaccine? | 232 (82.3) | 146 (91.8) | 86 (69.9) |
How much does your best female friend think you should receive the whooping cough vaccine? | 173 (61.3) | 109 (68.6) | 64 (52.0) |
In general, I want to do what my parents think I should do. | 39 (13.8) | 25 (15.7) | 14 (11.4) |
In general, I want to do what my doctor thinks I should do. | 158 (56.0) | 106 (66.7) | 52 (42.3) |
In general, I want to do what my best female friend thinks I should do. | 37 (13.1) | 22 (13.8) | 15 (12.2) |
Disease Risk (n = 97) | Myth Busting (n = 98) | Control (n = 87) | Kruskal-Wallis | |||||
---|---|---|---|---|---|---|---|---|
Range | Mean | SD | Mean | SD | Mean | SD | p-value | |
Attitudes | 3–21 | 18.41 | 5.01 | 18.36 | 4.72 | 17.55 | 5.36 | 0.17 |
Subjective norms | 6–30 | 14.13 | 5.27 | 13.98 | 4.89 | 13.64 | 5.26 | 0.83 |
Perceived Behavioural Control | 3–21 | 19.23 | 3.18 | 19.08 | 3.38 | 19.39 | 2.85 | 0.95 |
Intentions | 4–28 | 20.42 | 10.67 | 22.14 | 9.66 | 20.24 | 10.67 | 0.56 |
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Share and Cite
Ryan, M.; Marlow, L.A.V.; Forster, A. Countering Vaccine Hesitancy among Pregnant Women in England: The Case of Boostrix-IPV. Int. J. Environ. Res. Public Health 2020, 17, 4984. https://doi.org/10.3390/ijerph17144984
Ryan M, Marlow LAV, Forster A. Countering Vaccine Hesitancy among Pregnant Women in England: The Case of Boostrix-IPV. International Journal of Environmental Research and Public Health. 2020; 17(14):4984. https://doi.org/10.3390/ijerph17144984
Chicago/Turabian StyleRyan, Mairead, Laura A V Marlow, and Alice Forster. 2020. "Countering Vaccine Hesitancy among Pregnant Women in England: The Case of Boostrix-IPV" International Journal of Environmental Research and Public Health 17, no. 14: 4984. https://doi.org/10.3390/ijerph17144984
APA StyleRyan, M., Marlow, L. A. V., & Forster, A. (2020). Countering Vaccine Hesitancy among Pregnant Women in England: The Case of Boostrix-IPV. International Journal of Environmental Research and Public Health, 17(14), 4984. https://doi.org/10.3390/ijerph17144984