| Summary: | Pertussis vaccination of parents and household contacts (‘cocooning’) to protect newborn infants is
an established strategy in many countries, although uptake may be low. Many aspects may influence
such decision-making. We conducted a cross-sectional survey (NCT01890447) of households and
other close contacts of newborns aged ≤6 months (or of expectant mothers in their last trimester) in
Spain and Italy, using an adaptive discrete-choice experiment questionnaire. Aims were to assess the
relative importance of attributes influencing vaccine adoption, and to estimate variation in vaccine
adoption rates and the impact of cost on vaccination rates. Six hundred and fifteen participants
(Spain, n = 313; Italy, n = 302) completed the survey. Of 144 available questionnaire scenarios, the
most frequently selected (14% of respondents in both countries) were infant protection by household vaccination at vaccination center, recommendation by family physician and health authorities,
with information available on leaflets and websites. The attribute with highest median relative
importance was ‘reduction in source of infection’ in Spain (23.1%) and ‘vaccination location’ in
Italy (18.8%). Differences between other attributes were low in both countries, with media attributes
showing low importance. Over 80% of respondents indicated a definite or probable response to
vaccine adoption (at no-cost) with estimated probability of adoption of 89–98%; applying vaccine
costs (25€ per person) would reduce the probability of uptake by 7–20% in definite/probable
respondents. Awareness of these determinants is helpful in informing Health Authorities and
healthcare practitioners implementing a cocooning strategy for those populations where maternal
immunization is not a preferred option.
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