Meningococcal W135 Disease Vaccination Intent, the Netherlands, 2018-2019

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.

Keywords: IMD; Neisseria meningitidis; W135; adolescent; attitude; bacteria; communication; disease outbreaks; health behavior; knowledge; meningococcal disease; mental models; parents; perception; teenager; the Netherlands; vaccination; vaccines.

Figure 1

Variable importance ranking among parents in study of vaccination intent regarding IMD caused by Neisseria meningitidis strain W135, the Netherlands, 2018–2019. The 25 strongest predictors (i.e., knowledge and belief items [Table] and control variables), are ranked top to bottom, based on their ability to predict parental meningococcal conjugate [MenACWY] vaccination intention. Control variables are age, sex, education, income, region, social class, region of residence, vaccination record of the teenager, whether the respondent was aware of the MenACWY vaccination campaign, and whether teenagers and their parents were part of the first (cohorts 2004–2005) or the second MenACWY vaccination target group (cohorts 2001–2003). IMD, invasive meningococcal disease.

Figure 2

Variable importance ranking among teenagers in study of vaccination intent regarding IMD caused by Neisseria meningitidis strain W135, the Netherlands, 2018–2019. The 25 strongest predictors (i.e., knowledge and belief items [Table] and control variables) are ranked top to bottom, based on their ability to predict meningococcal conjugate (MenACWY) vaccination intention among teenagers. Control variables are age, sex, education, income, region, social class, region of residence, vaccination record of the teenager, whether the respondent was aware of the MenACWY vaccination campaign, and whether teenagers and their parents were part of the first (cohorts 2004–2005) or second MenACWY vaccination target group (cohorts 2001–2003). IMD, invasive meningococcal disease.

Figure 3

Variable importance ranking among teenagers (combined model) in study of vaccination intent regarding IMD caused by Neisseria meningitidis strain W135, the Netherlands, 2018–2019. The 25 strongest predictors (i.e., knowledge and belief items [Table] and control variables) are ranked top to bottom, based on their ability to predict meningococcal conjugate (MenACWY) vaccination intention among teenagers with a parent in the sample. This model includes both the knowledge and beliefs (Table) of teenagers, as well as the knowledge, beliefs, and MenACWY vaccination intention of their parents and the control variables from both groups as independent variables. Control variables are age, sex, education, income, region, social class, region of residence, vaccination record of the teenager, whether the respondent was aware of the MenACWY vaccination campaign, and whether teenagers and their parents were part of the first MenACWY vaccination target group (cohorts 2004–2005) or the second MenACWY vaccination target group (cohorts 2001–2003). IMD, invasive meningococcal disease.