title: Universal tetanus, diphtheria, acellular pertussis (Tdap) vaccination of adults: What the Canadian public knows and wants to know.
abstract: Tetanus, diphtheria, and acellular pertussis vaccine (Tdap) is recommended for all adults in Canada but uptake is low. This study measured the knowledge, attitudes, beliefs, and behaviors of Canadian adults to identify potential barriers and facilitators to Tdap uptake. A survey was undertaken on a geographically representative sample of Canadian adults (n=4023) and 8 focus groups (62 participants) were conducted nationwide. The survey revealed that knowledge about pertussis and Tdap was low (38.3% correct answers). Only 36.0% of respondents reported being aware that all adults were recommended to receive Tdap and only 10.7% reported being immunized; 36.7% did not know whether they had received Tdap. Respondents who were aware of the immunization recommendations were twice as likely to be immunized (16.6% vs. 8.3%; p<0.001). Only 9.3% believed that their health care provider thought that Tdap was important for adults. The focus group data supported the survey results. Participants wanted information about pertussis and Tdap communicated through multiple modalities, but a recommendation by their family physician was most important to their decision to be immunized or not. This study demonstrates that current recommendations for universal adult vaccination with Tdap are not reaching the general public in Canada and an alternative strategy will be required to improve Tdap vaccine uptake.
authors.affiliation: Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and the Nova Scotia Health Authority, Halifax, Nova Scotia, Canada; School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: B A
authors.initials: BA
authors.lastname: Halperin
authors.affiliation: Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and the Nova Scotia Health Authority, Halifax, Nova Scotia, Canada; School of Nursing, St. Francis Xavier University, Antigonish, Nova Scotia, Canada.
authors.forename: D
authors.initials: D
authors.lastname: MacDougall
authors.affiliation: Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and the Nova Scotia Health Authority, Halifax, Nova Scotia, Canada.
authors.forename: D
authors.initials: D
authors.lastname: MacKinnon-Cameron
authors.affiliation: Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and the Nova Scotia Health Authority, Halifax, Nova Scotia, Canada.
authors.forename: L
authors.initials: L
authors.lastname: Li
authors.affiliation: Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and the Nova Scotia Health Authority, Halifax, Nova Scotia, Canada; Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: S A
authors.initials: SA
authors.lastname: McNeil
authors.affiliation: Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and the Nova Scotia Health Authority, Halifax, Nova Scotia, Canada; Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: J M
authors.initials: JM
authors.lastname: Langley
authors.affiliation: Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and the Nova Scotia Health Authority, Halifax, Nova Scotia, Canada; Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Microbiology & Immunology, Dalhousie University, Halifax, Nova Scotia, Canada. Electronic address: scott.halperin@dal.ca.
authors.forename: S A
authors.initials: SA
authors.lastname: Halperin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada / Q000453:epidemiology; D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000706:statistics & numerical data; D014917:Whooping Cough / Q000453:epidemiology* / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines
keywords: Adult immunization; Knowledge, attitudes, beliefs; Pertussis; Pertussis vaccine; Tdap; Vaccine coverage