COMPARISON OF PARENTAL AND HEALTH-CARE PROFESSIONAL PREFERENCES FOR THE ACELLULAR OR WHOLE-CELL PERTUSSIS-VACCINE

Objective, To compare the preferences of mothers, physicians and nurse s for use of a new generic acellular pertussis vaccine which is less r eactogenic than and as effective as a conventional whole cell vaccine, but which would require multiple injections rather than a single inje ction to deliver all other recommended vaccines. Methods. A convenienc e sample of 400 mothers of 1-month-old infants, 100 immunizing physici ans and 100 immunizing nurses were surveyed over a 2 1/2-month period. Information about pertussis and both whole cell and acellular pertuss is vaccines was provided, and a questionnaire was used to assess knowl edge and attitudes about pertussis vaccine, vaccine preference and rea sons for selection, In addition to their own preferences health care p rofessionals were asked to predict which vaccine mothers would prefer and to predict why mothers would choose a particular vaccine, Results, Mothers preferred the acellular vaccine over the whole cell vaccine b y a nearly 2:1 margin (57.3% vs, 29.5%), Health care professionals pre ferred the whole cell vaccine by the same 2:1 margin (61.1% vs, 29.3%) . Only 19.1% of health care professionals predicted that mothers would accept the acellular vaccine if it meant multiple injections, More mo thers were concerned by the common reactions caused by the whole cell vaccine (75.8% vs. 52%; P = 0.001); more health care professionals fel t that multiple injections were stressful (89% vs, 70%; P = 0.001) and that they could be associated with long term effects (17% vs, 8.8%; P = 0.003). More health care professionals than mothers said that the n eed for multiple injections would influence their decision to accept t he acellular vaccine (76.5% vs, 38.3%; P = 0.001). Conclusions. Mother s prefer a less reactogenic vaccine product even if it requires multip le injections. Health care professionals are more concerned about mult iple injections and are poor predictors of mothers' vaccine preference , Multiple injections may be more a barrier to immunization for health care professionals than for mothers.