Abstract

To control the rise in Neisseria meningitidis strain W infections, during 2018–2019, the Netherlands launched a catch-up meningococcal conjugate (MenACWY) vaccination campaign for teenagers (13–18 years of age). Applying a mental models approach, we surveyed teenagers and their parents about their knowledge and beliefs about meningococcal disease, the MenACWY vaccination, vaccinations in general, and their MenACWY vaccination intentions. Using random forest analysis, we studied predictions of vaccination intentions by knowledge and beliefs. Survey response rate was 52.8% among teenagers and 59.4% among parents. MenACWY vaccination intentions were best predicted by knowledge and beliefs about vaccinations in general, surpassing knowledge and beliefs about meningococcal disease and the MenACWY vaccination. For teenagers, their parents’ intention that the teenager be vaccinated was a strong predictor of the teenagers’ own vaccination intention. To optimize vaccination uptake during future outbreaks, we recommend that communications emphasize the effectiveness and safety of vaccines and continue to focus on parents.

Highlights

  • To control the rise in Neisseria meningitidis strain W infections, during 2018–2019, the Netherlands launched a catch-up meningococcal conjugate (MenACWY) vaccination campaign for teenagers (13–18 years of age)

  • On the basis of the mental models approach, at the onset of the MenACWY vaccination campaign in September 2018, we explored aspects of knowledge and specific beliefs about meningococcal disease, the MenACWY vaccination, and vaccines in general among teenagers in the Netherlands invited for the MenACWY vaccination and their parents

  • MenACWY Vaccination Intention Teenagers were generally willing to be vaccinated with the MenACWY vaccine, and their parents were willing to have them vaccinated

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Summary

Introduction

To control the rise in Neisseria meningitidis strain W infections, during 2018–2019, the Netherlands launched a catch-up meningococcal conjugate (MenACWY) vaccination campaign for teenagers (13–18 years of age). Applying a mental models approach, we surveyed teenagers and their parents about their knowledge and beliefs about meningococcal disease, the MenACWY vaccination, vaccinations in general, and their MenACWY vaccination intentions. MenACWY vaccination intentions were best predicted by knowledge and beliefs about vaccinations in general, surpassing knowledge and beliefs about meningococcal disease and the MenACWY vaccination. Various studies have been performed to determine how persons make vaccination decisions, including those regarding vaccination against meningococcal disease [3,4,5,6,7,8,9,10,11,12] This academic interest in vaccination decisions has increased over the past few years after the gradual decline of vaccination uptake observed in many countries. In contrast to most studies that have shown the influence of knowledge and beliefs on vaccination decisions (e.g., those applying the theory of planned behavior [14,15], the protection motivation theory [16,17], and the health belief model [18,19]), our aim with this study was not to fully understand vaccination behavior but to gain insights into specific aspects of knowledge and beliefs that could provide concrete

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