title: Negative attitude and low intention to vaccinate universally against varicella among public health professionals and parents in the Netherlands: two internet surveys.
abstract: BACKGROUND
  Prior to introduction of universal varicella vaccination, it is crucial to gain insight into the willingness to vaccinate among the population. This is because suboptimal national vaccination coverage might increase the age of infection in children, which will lead to higher complication rates. We studied the attitude and intention to vaccinate against varicella among Dutch public health professionals who execute the National Immunisation Programme (NIP), and parents.
  
  
  METHODS
  Medical doctors and nurses of regional public health services (RPHS) and child health clinics (CHC), and a random sample of parents received an internet survey on varicella vaccination. Separate logistic regression models were used to identify determinants for a positive attitude (professionals) or a positive intention (parents) to vaccinate against varicella within the NIP (free of charge).
  
  
  RESULTS
  The questionnaire was completed by 181 RPHS professionals (67%), 260 CHC professionals (46%), and 491 parents (33%). Of professionals, 21% had a positive attitude towards universal varicella vaccination, while 72% preferred to limit vaccination to high-risk groups only. Of parents, 28% had a positive intention to vaccinate their child against varicella within the NIP. The strongest determinant for a positive attitude or intention to vaccinate against varicella among professionals and parents was the belief that varicella is a disease serious enough to vaccinate against.
  
  
  CONCLUSIONS
  We showed that a majority of the Dutch public health professionals and parents in this study have a negative attitude or low intention to vaccinate universally against varicella, as a result of the perceived low severity of the disease. Most participating professionals support selective vaccination to prevent varicella among high-risk groups.
authors.affiliation: Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1 (internal P.O. Box 75), 3720 BA, Bilthoven, The Netherlands. alies.van.lier@rivm.nl.
authors.forename: Alies
authors.initials: A
authors.lastname: van Lier
authors.affiliation: Academic Collaborative Centre AMPHI, Department of Primary and Community Care, Radboud university medical center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
authors.forename: Alma
authors.initials: A
authors.lastname: Tostmann
authors.affiliation: Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1 (internal P.O. Box 75), 3720 BA, Bilthoven, The Netherlands.|Department of Work & Social Psychology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
authors.forename: Irene A
authors.initials: IA
authors.lastname: Harmsen
authors.affiliation: Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1 (internal P.O. Box 75), 3720 BA, Bilthoven, The Netherlands.
authors.forename: Hester E
authors.initials: HE
authors.lastname: de Melker
authors.affiliation: Regional Public Health Service 'GGD Gelderland-Zuid', P.O. Box 1120, 6501 BC, Nijmegen, The Netherlands.|Academic Collaborative Centre AMPHI, Department of Primary and Community Care, Radboud university medical center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
authors.forename: Jeannine L A
authors.initials: JL
authors.lastname: Hautvast
authors.affiliation: Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1 (internal P.O. Box 75), 3720 BA, Bilthoven, The Netherlands.|Regional Public Health Service 'GGD Gelderland-Zuid', P.O. Box 1120, 6501 BC, Nijmegen, The Netherlands.
authors.forename: Wilhelmina L M
authors.initials: WL
authors.lastname: Ruijs
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002644:Chickenpox / Q000517:prevention & control*; D019433:Chickenpox Vaccine / Q000008:administration & dosage; D002648:Child; D002662:Child Health Services; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009426:Netherlands; D010290:Parents / Q000523:psychology*; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D019433:Chickenpox Vaccine
keywords: Chickenpox; Epidemiology; Intention; Vaccination; Varicella; Varicella Zoster Virus