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

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

*Corresponding author for this work

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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 play 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.
Original languageEnglish
Article number828
Pages (from-to)1-14
Number of pages14
JournalBMC Public Health
Issue number1
Publication statusPublished - 1 Jun 2020


  • Adult vaccination
  • Childhood vaccination
  • Decision-making
  • Discrete choice experiment
  • Vaccination behaviour

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