Skip to main content
Top
Published in: BMC Public Health 1/2020

Open Access 01-12-2020 | Vaccination | Research article

Preferential differences in vaccination decision-making for oneself or one’s child in The Netherlands: a discrete choice experiment

Authors: Joram Hoogink, Frederik Verelst, Roselinde Kessels, Albert Jan van Hoek, Aura Timen, Lander Willem, Philippe Beutels, Jacco Wallinga, G. Ardine de Wit

Published in: BMC Public Health | Issue 1/2020

Login to get access

Abstract

Background

To optimize the focus of future public information campaigns in The Netherlands promoting the uptake of vaccines among adults and children, we quantified the contribution of several attributes to the vaccination decision.

Method

We performed a discrete choice experiment (DCE) among Dutch adults including six attributes, i.e. vaccine effectiveness, vaccine-preventable burden of disease (specified in severity and frequency), accessibility of vaccination in terms of co-payment and prescription requirements, frequency of mild side-effects, population-level vaccination coverage and local vaccination coverage among family and friends. Participants answered the DCE from their own perspective (‘oneself’ group) or with regard to a vaccine decision for their youngest child (‘child’ group). The data was analysed by means of panel mixed logit models.

Results

We included 1547 adult participants (825 ‘oneself’ and 722 ‘child’). Vaccine effectiveness was the most important attribute in the ‘oneself’ group, followed by burden of disease (relative importance (RI) 78%) and accessibility (RI 76%). In the ‘child’ group, burden of disease was most important, but tied closely with vaccine effectiveness (RI 97%). Of less importance was the risk of mild vaccine-related side-effects and both population and local vaccination coverage. Interestingly, participants were more willing to vaccinate when uptake among the population or family and friends was high, indicating that social influence and social norms plays a role.

Conclusions

Vaccine effectiveness and disease severity are key attributes in vaccination decision-making for adults making a decision for themselves and for parents who decide for their children. Hence, public information campaigns for both adult and child vaccination should primarily focus on these two attributes. In addition, reinforcing social norms may be considered.
Appendix
Available only for authorised users
Literature
1.
go back to reference WHO. Global Vaccine Action Plan 2011-2020. Geneva, Switzerland; 2013. WHO. Global Vaccine Action Plan 2011-2020. Geneva, Switzerland; 2013.
2.
go back to reference Greenwood B. The contribution of vaccination to global health: past, present and future. Phil Trans R Soc B. 2014;369:20130433.CrossRef Greenwood B. The contribution of vaccination to global health: past, present and future. Phil Trans R Soc B. 2014;369:20130433.CrossRef
3.
go back to reference Larson HJ, de Figueiredo A, Xiahong Z, Schulz WS, Verger P, Johnston IG, Cook AR, Jones NS. The state of vaccine confidence 2016: global insights through a 67-country survey. EBio Med. 2016;12:295–301. Larson HJ, de Figueiredo A, Xiahong Z, Schulz WS, Verger P, Johnston IG, Cook AR, Jones NS. The state of vaccine confidence 2016: global insights through a 67-country survey. EBio Med. 2016;12:295–301.
4.
go back to reference Smith TC. Vaccine rejection and hesitancy: a review and call to action. Open Forum Infect Dis. 2017;4. Smith TC. Vaccine rejection and hesitancy: a review and call to action. Open Forum Infect Dis. 2017;4.
5.
go back to reference Sadaf A, Richards JL, Glanz J, Salmon DA, Omer SB. A systematic review of interventions for reducing parental vaccine refusal and vaccine hesitancy. Vaccine. 2013;31:4293–304.CrossRef Sadaf A, Richards JL, Glanz J, Salmon DA, Omer SB. A systematic review of interventions for reducing parental vaccine refusal and vaccine hesitancy. Vaccine. 2013;31:4293–304.CrossRef
6.
go back to reference MacDonald NE. Vaccine hesitancy: definition, scope and determinants. Vaccine. 2015;33:4161–4.CrossRef MacDonald NE. Vaccine hesitancy: definition, scope and determinants. Vaccine. 2015;33:4161–4.CrossRef
7.
go back to reference Van Lier E, Geraedts J, Oomen P, Giesbers H, Van Vliet J, Drijfhout I, Zonnenberg-Hoff I, de Melker H. Vaccinatiegraad en jaarverslag Rijksvaccinatieprogramma Nederland 2017 [Immunisation coverage and annual report National Immunisation Programme in the Netherlands 2017.]. Bilthoven, The Netherlands; 2018. Van Lier E, Geraedts J, Oomen P, Giesbers H, Van Vliet J, Drijfhout I, Zonnenberg-Hoff I, de Melker H. Vaccinatiegraad en jaarverslag Rijksvaccinatieprogramma Nederland 2017 [Immunisation coverage and annual report National Immunisation Programme in the Netherlands 2017.]. Bilthoven, The Netherlands; 2018.
8.
go back to reference Dube E, Vivion M, MacDonald NE. Vaccine hesitancy, vaccine refusal and the anti-vaccine movement: influence, impact and implications. Expert Rev Vaccines. 2015;14:99–117.CrossRef Dube E, Vivion M, MacDonald NE. Vaccine hesitancy, vaccine refusal and the anti-vaccine movement: influence, impact and implications. Expert Rev Vaccines. 2015;14:99–117.CrossRef
9.
go back to reference Larson HJ, Jarrett C, Eckersberger E, Smith DM, Paterson P. Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: a systematic review of published literature, 2007-2012. Vaccine. 2014;32:2150–9.CrossRef Larson HJ, Jarrett C, Eckersberger E, Smith DM, Paterson P. Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: a systematic review of published literature, 2007-2012. Vaccine. 2014;32:2150–9.CrossRef
10.
go back to reference Schmid P, Rauber D, Betsch C, Lidolt G, Denker M-L. Barriers of influenza vaccination intention and behavior–a systematic review of influenza vaccine hesitancy, 2005–2016. PLoS One. 2017;12:e0170550.CrossRef Schmid P, Rauber D, Betsch C, Lidolt G, Denker M-L. Barriers of influenza vaccination intention and behavior–a systematic review of influenza vaccine hesitancy, 2005–2016. PLoS One. 2017;12:e0170550.CrossRef
11.
go back to reference Schuster M, Eskola J, Duclos P, SWGoV H. Review of vaccine hesitancy: rationale, remit and methods. Vaccine. 2015;33:4157–60.CrossRef Schuster M, Eskola J, Duclos P, SWGoV H. Review of vaccine hesitancy: rationale, remit and methods. Vaccine. 2015;33:4157–60.CrossRef
12.
go back to reference Harmsen IA, Mollema L, Ruiter RA, Paulussen TG, de Melker HE, Kok G. Why parents refuse childhood vaccination: a qualitative study using online focus groups. BMC Public Health. 2013;13:1183.CrossRef Harmsen IA, Mollema L, Ruiter RA, Paulussen TG, de Melker HE, Kok G. Why parents refuse childhood vaccination: a qualitative study using online focus groups. BMC Public Health. 2013;13:1183.CrossRef
13.
go back to reference Ventola CL. Immunization in the United States: recommendations, barriers, and measures to improve compliance. Pharmacy Ther. 2016;41:426. Ventola CL. Immunization in the United States: recommendations, barriers, and measures to improve compliance. Pharmacy Ther. 2016;41:426.
14.
go back to reference Stein RA. The golden age of anti-vaccine conspiracies. Germs. 2017;7:168–70.CrossRef Stein RA. The golden age of anti-vaccine conspiracies. Germs. 2017;7:168–70.CrossRef
15.
go back to reference Salmon DA, Dudley MZ, Glanz JM, Omer SB. Vaccine hesitancy: causes, consequences, and a call to action. Vaccine. 2015;33:D66–71.CrossRef Salmon DA, Dudley MZ, Glanz JM, Omer SB. Vaccine hesitancy: causes, consequences, and a call to action. Vaccine. 2015;33:D66–71.CrossRef
16.
go back to reference Ibuka Y, Li M, Vietri J, Chapman GB, Galvani AP. Free-riding behavior in vaccination decisions: an experimental study. PLoS One. 2014;9:e87164.CrossRef Ibuka Y, Li M, Vietri J, Chapman GB, Galvani AP. Free-riding behavior in vaccination decisions: an experimental study. PLoS One. 2014;9:e87164.CrossRef
17.
go back to reference Böhm R, Betsch C, Korn L. Selfish-rational non-vaccination: experimental evidence from an interactive vaccination game. J Econ Behav Organ. 2016;131:183–95.CrossRef Böhm R, Betsch C, Korn L. Selfish-rational non-vaccination: experimental evidence from an interactive vaccination game. J Econ Behav Organ. 2016;131:183–95.CrossRef
18.
go back to reference Hall J, Kenny P, King M, Louviere J, Viney R, Yeoh A. Using stated preference discrete choice modelling to evaluate the introduction of varicella vaccination. Health Econ. 2002;11:457–65.CrossRef Hall J, Kenny P, King M, Louviere J, Viney R, Yeoh A. Using stated preference discrete choice modelling to evaluate the introduction of varicella vaccination. Health Econ. 2002;11:457–65.CrossRef
19.
go back to reference Gidengil C, Lieu TA, Payne K, Rusinak D, Messonnier M, Prosser LA. Parental and societal values for the risks and benefits of childhood combination vaccines. Vaccine. 2012;30:3445–52.CrossRef Gidengil C, Lieu TA, Payne K, Rusinak D, Messonnier M, Prosser LA. Parental and societal values for the risks and benefits of childhood combination vaccines. Vaccine. 2012;30:3445–52.CrossRef
20.
go back to reference Determann D, Korfage IJ, Lambooij MS, Bliemer M, Richardus JH, Steyerberg EW, de Bekker-Grob EW. Acceptance of vaccinations in pandemic outbreaks: a discrete choice experiment. PLoS One. 2014;9:e102505.CrossRef Determann D, Korfage IJ, Lambooij MS, Bliemer M, Richardus JH, Steyerberg EW, de Bekker-Grob EW. Acceptance of vaccinations in pandemic outbreaks: a discrete choice experiment. PLoS One. 2014;9:e102505.CrossRef
21.
go back to reference Eilers R, de Melker HE, Veldwijk J, Krabbe PFM. Vaccine preferences and acceptance of older adults. Vaccine. 2017;35:2823–30.CrossRef Eilers R, de Melker HE, Veldwijk J, Krabbe PFM. Vaccine preferences and acceptance of older adults. Vaccine. 2017;35:2823–30.CrossRef
22.
go back to reference Veldwijk J, Lambooij MS, Bruijning-Verhagen PC, Smit HA, de Wit GA. Parental preferences for rotavirus vaccination in young children: a discrete choice experiment. Vaccine. 2014;32:6277–83.CrossRef Veldwijk J, Lambooij MS, Bruijning-Verhagen PC, Smit HA, de Wit GA. Parental preferences for rotavirus vaccination in young children: a discrete choice experiment. Vaccine. 2014;32:6277–83.CrossRef
23.
go back to reference Verelst F, Kessels R, Delva W, Beutels P, Willem L. Drivers of vaccine decision-making in South Africa: a discrete choice experiment. Vaccine. 2019;37:2079–89.CrossRef Verelst F, Kessels R, Delva W, Beutels P, Willem L. Drivers of vaccine decision-making in South Africa: a discrete choice experiment. Vaccine. 2019;37:2079–89.CrossRef
24.
go back to reference Verelst F, Willem L, Kessels R, Beutels P. Individual decisions to vaccinate one's child or oneself: a discrete choice experiment rejecting free-riding motives. Soc Sci Med. 2018;207:106–16.CrossRef Verelst F, Willem L, Kessels R, Beutels P. Individual decisions to vaccinate one's child or oneself: a discrete choice experiment rejecting free-riding motives. Soc Sci Med. 2018;207:106–16.CrossRef
25.
go back to reference Central Bureau for Statistics. Population; sex, age and nationality, 1 January. 2018. Accessed on February 20 2019. https://opendata.cbs.nl/statline/portal.html?_la=en&_catalog=CBS&tableId=03743eng&_theme=1041. Central Bureau for Statistics. Population; sex, age and nationality, 1 January. 2018. Accessed on February 20 2019. https://​opendata.​cbs.​nl/​statline/​portal.​html?​_​la=​en&​_​catalog=​CBS&​tableId=​03743eng&​_​theme=​1041.​
26.
go back to reference Ruijs WLM, Hautvast JLA, van Ansem WJC, Akkermans RP, van’t Spijker K, Hulscher MEJL, van der Velden K. Measuring vaccination coverage in a hard to reach minority. Eur J Pub Health. 2011;22:359–64.CrossRef Ruijs WLM, Hautvast JLA, van Ansem WJC, Akkermans RP, van’t Spijker K, Hulscher MEJL, van der Velden K. Measuring vaccination coverage in a hard to reach minority. Eur J Pub Health. 2011;22:359–64.CrossRef
27.
go back to reference Ruijs WLM, Hautvast JLA, van der Velden K, de Vos S, Knippenberg H, Hulscher MEJL. Religious subgroups influencing vaccination coverage in the Dutch bible belt: an ecological study. BMC Public Health. 2011;11:102.CrossRef Ruijs WLM, Hautvast JLA, van der Velden K, de Vos S, Knippenberg H, Hulscher MEJL. Religious subgroups influencing vaccination coverage in the Dutch bible belt: an ecological study. BMC Public Health. 2011;11:102.CrossRef
28.
go back to reference Ruijs WLM, Hautvast JLA, van Ijzendoorn G, van Ansem WJC, van der Velden K, Hulscher MEJL. How orthodox protestant parents decide on the vaccination of their children: a qualitative study. BMC Public Health. 2012;12:408.CrossRef Ruijs WLM, Hautvast JLA, van Ijzendoorn G, van Ansem WJC, van der Velden K, Hulscher MEJL. How orthodox protestant parents decide on the vaccination of their children: a qualitative study. BMC Public Health. 2012;12:408.CrossRef
29.
go back to reference Lugner A, Mollema L, Ruijs W, Hahne S. A cost-utility analysis of antenatal screening to prevent congenital rubella syndrome. Epidemiol Infect. 2010;138:1172–84.CrossRef Lugner A, Mollema L, Ruijs W, Hahne S. A cost-utility analysis of antenatal screening to prevent congenital rubella syndrome. Epidemiol Infect. 2010;138:1172–84.CrossRef
30.
go back to reference Lehmann BA, de Melker HE, Timmermans DRM, Mollema L. Informed decision making in the context of childhood immunization. Patient Educ Couns. 2017;100:2339–45.CrossRef Lehmann BA, de Melker HE, Timmermans DRM, Mollema L. Informed decision making in the context of childhood immunization. Patient Educ Couns. 2017;100:2339–45.CrossRef
31.
go back to reference Kessels R, Jones B, Goos P, Vandebroek M. The usefulness of Bayesian optimal designs for discrete choice experiments. Appl Stoch Model Bus Ind. 2011;27:173–88.CrossRef Kessels R, Jones B, Goos P, Vandebroek M. The usefulness of Bayesian optimal designs for discrete choice experiments. Appl Stoch Model Bus Ind. 2011;27:173–88.CrossRef
32.
go back to reference Luyten J, Kessels R, Goos P, Beutels P. Public preferences for prioritizing preventive and curative health care interventions: a discrete choice experiment. Value Health. 2015;18:224–33.CrossRef Luyten J, Kessels R, Goos P, Beutels P. Public preferences for prioritizing preventive and curative health care interventions: a discrete choice experiment. Value Health. 2015;18:224–33.CrossRef
33.
go back to reference Kessels R, Jones B, Goos P. An improved two-stage variance balance approach for constructing partial profile designs for discrete choice experiments. Appl Stoch Model Bus Ind. 2015;31:626–48.CrossRef Kessels R, Jones B, Goos P. An improved two-stage variance balance approach for constructing partial profile designs for discrete choice experiments. Appl Stoch Model Bus Ind. 2015;31:626–48.CrossRef
34.
go back to reference Kessels R, Van Herck P, Dancet E, Annemans L, Sermeus W. How to reform western care payment systems according to physicians, policy makers, healthcare executives and researchers: a discrete choice experiment. BMC Health Serv Res. 2015;15:191.CrossRef Kessels R, Van Herck P, Dancet E, Annemans L, Sermeus W. How to reform western care payment systems according to physicians, policy makers, healthcare executives and researchers: a discrete choice experiment. BMC Health Serv Res. 2015;15:191.CrossRef
35.
go back to reference Oteng B, Marra F, Lynd LD, Ogilvie G, Patrick D, Marra CA. Evaluating societal preferences for human papillomavirus vaccine and cervical smear test screening programme. Sex Transm Infect. 2011;87:52–7.CrossRef Oteng B, Marra F, Lynd LD, Ogilvie G, Patrick D, Marra CA. Evaluating societal preferences for human papillomavirus vaccine and cervical smear test screening programme. Sex Transm Infect. 2011;87:52–7.CrossRef
36.
go back to reference de Bekker-Grob EW, Hofman R, Donkers B, van Ballegooijen M, Helmerhorst TJ, Raat H, Korfage IJ. Girls’ preferences for HPV vaccination: a discrete choice experiment. Vaccine. 2010;28:6692–7.CrossRef de Bekker-Grob EW, Hofman R, Donkers B, van Ballegooijen M, Helmerhorst TJ, Raat H, Korfage IJ. Girls’ preferences for HPV vaccination: a discrete choice experiment. Vaccine. 2010;28:6692–7.CrossRef
37.
go back to reference Sadique MZ, Devlin N, Edmunds WJ, Parkin D. The effect of perceived risks on the demand for vaccination: results from a discrete choice experiment. PLoS One. 2013;8:e54149.CrossRef Sadique MZ, Devlin N, Edmunds WJ, Parkin D. The effect of perceived risks on the demand for vaccination: results from a discrete choice experiment. PLoS One. 2013;8:e54149.CrossRef
38.
go back to reference Bishai D, Brice R, Girod I, Saleh A, Ehreth J. Conjoint analysis of French and German parents willingness to pay for meningococcal vaccine. Pharmacoeconomics. 2007;25:143–54.CrossRef Bishai D, Brice R, Girod I, Saleh A, Ehreth J. Conjoint analysis of French and German parents willingness to pay for meningococcal vaccine. Pharmacoeconomics. 2007;25:143–54.CrossRef
39.
go back to reference Clark MD, Determann D, Petrou S, Moro D, de Bekker-Grob EW. Discrete choice experiments in health economics: a review of the literature. Pharmacoeconomics. 2014;32:883–902.CrossRef Clark MD, Determann D, Petrou S, Moro D, de Bekker-Grob EW. Discrete choice experiments in health economics: a review of the literature. Pharmacoeconomics. 2014;32:883–902.CrossRef
40.
go back to reference de Bekker-Grob EW, Ryan M, Gerard K. Discrete choice experiments in health economics: a review of the literature. Health Econ. 2012;21:145–72.CrossRef de Bekker-Grob EW, Ryan M, Gerard K. Discrete choice experiments in health economics: a review of the literature. Health Econ. 2012;21:145–72.CrossRef
41.
go back to reference Verelst F, Willem L, Beutels P. Behavioural change models for infectious disease transmission: a systematic review (2010-2015). J R Soc Interface. 2016;13. Verelst F, Willem L, Beutels P. Behavioural change models for infectious disease transmission: a systematic review (2010-2015). J R Soc Interface. 2016;13.
42.
go back to reference Bults M, Beaujean DJMA, de Zwart O, Kok G, van Empelen P, van Steenbergen JE, Richardus JH, Voeten HACM. Perceived risk, anxiety, and behavioural responses of the general public during the early phase of the influenza a (H1N1) pandemic in the Netherlands: results of three consecutive online surveys. BMC Public Health. 2011;11:2.CrossRef Bults M, Beaujean DJMA, de Zwart O, Kok G, van Empelen P, van Steenbergen JE, Richardus JH, Voeten HACM. Perceived risk, anxiety, and behavioural responses of the general public during the early phase of the influenza a (H1N1) pandemic in the Netherlands: results of three consecutive online surveys. BMC Public Health. 2011;11:2.CrossRef
43.
go back to reference Veldwijk J, van der Heide I, Rademakers J, Schuit AJ, de Wit GA, Uiters E, Lambooij MS. Preferences for vaccination: does health literacy make a difference? Med Decis Mak. 2015;35:948–58.CrossRef Veldwijk J, van der Heide I, Rademakers J, Schuit AJ, de Wit GA, Uiters E, Lambooij MS. Preferences for vaccination: does health literacy make a difference? Med Decis Mak. 2015;35:948–58.CrossRef
44.
go back to reference Chew LD, Bradley KA, Boyko EJ. Brief questions to identify patients with inadequate health literacy. Fam Med. 2004;36:588–94.PubMed Chew LD, Bradley KA, Boyko EJ. Brief questions to identify patients with inadequate health literacy. Fam Med. 2004;36:588–94.PubMed
45.
go back to reference Chew LD, Griffin JM, Partin MR, Noorbaloochi S, Grill JP, Snyder A, Bradley KA, Nugent SM, Baines AD, Vanryn M. Validation of screening questions for limited health literacy in a large VA outpatient population. J Gen Intern Med. 2008;23:561–6.CrossRef Chew LD, Griffin JM, Partin MR, Noorbaloochi S, Grill JP, Snyder A, Bradley KA, Nugent SM, Baines AD, Vanryn M. Validation of screening questions for limited health literacy in a large VA outpatient population. J Gen Intern Med. 2008;23:561–6.CrossRef
46.
go back to reference JMP®. Version Pro 14. Cary, NC: SAS Institute Inc.; 1989–2019. JMP®. Version Pro 14. Cary, NC: SAS Institute Inc.; 1989–2019.
47.
go back to reference Organization WH. Report of the SAGE working group on vaccine hesitancy. Geneva, Switzerland; 2014. Organization WH. Report of the SAGE working group on vaccine hesitancy. Geneva, Switzerland; 2014.
Metadata
Title
Preferential differences in vaccination decision-making for oneself or one’s child in The Netherlands: a discrete choice experiment
Authors
Joram Hoogink
Frederik Verelst
Roselinde Kessels
Albert Jan van Hoek
Aura Timen
Lander Willem
Philippe Beutels
Jacco Wallinga
G. Ardine de Wit
Publication date
01-12-2020
Publisher
BioMed Central
Keyword
Vaccination
Published in
BMC Public Health / Issue 1/2020
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-020-08844-w

Other articles of this Issue 1/2020

BMC Public Health 1/2020 Go to the issue