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. 2022 Sep;69(5):e2779-e2788.
doi: 10.1111/tbed.14629. Epub 2022 Jun 29.

Perception of low social pressure and lack of capacity reduces vaccination compliance - The case of lumpy skin disease

Michal Morgenstern  1 , Jaap Sok  2 , Eyal Klement  1
Affiliations

Perception of low social pressure and lack of capacity reduces vaccination compliance - The case of lumpy skin disease

Michal Morgenstern et al. Transbound Emerg Dis. 2022 Sep.

Abstract

Successful prevention of epidemics depends on implementation of control measures, including vaccine compliance and maintenance of high vaccination coverage for long periods. However, to the best of our knowledge, a study of the temporal dynamics of compliance in voluntary vaccination campaigns and of the factors which influence them was never published. In this study, we investigated the factors influencing the dynamics of vaccination compliance against lumpy skin disease (LSD) after the occurrence of LSD epidemics in Israel in 2012-2013 and 2019. From 2016 to 2019, we followed voluntary LSD annual vaccination among a cohort of 566 farmers and used questionnaires based on the theory of planned behaviour to investigate the incentives influencing vaccine compliance among 90 farmers. The results showed a reduction in vaccination against LSD from 61% in 2016 to 27% in 2019 and a very strong association between prior vaccination and vaccination compliance. The actual vaccination by farmers who stated a positive intention to vaccinate was 4.5 times higher than farmers who did not (p-value = .007). However, half of the highly intended farmers eventually did not vaccinate their herd. These farmers were significantly more concerned by manpower and vaccine price compared to their vaccinating counterparts, pointing to vaccination effort perceptions as a major factor influencing compliance. In addition, we found that farmers who answered the questionnaires before the LSD epidemic of 2019 perceived significantly less pressure to vaccinate imposed by veterinary organizations (private and governmental) than farmers answering them during or after the epidemic. We conclude that the veterinarian-associated social pressure is a major compliance-enhancing factor, influenced by the occurrence of an epidemic. Our findings suggest that the deterioration of vaccination compliance after an epidemic can be mitigated by maintenance of pressure to vaccinate by veterinarians. Manpower support and vaccine discounts may be advocated to promote vaccine compliance.

Keywords: epidemic; lumpy skin disease; theory of planned behaviour; vaccination compliance; vaccination compliance dynamics; voluntary vaccination.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
A graphic description of the study population. The study included two main datasets: (1) Vaccination and demographic data on 566 dairy farms insured by the Hachaklait organization during the years 2016–2019 (Dataset 1). (2) Ninety TPB questionnaires filled‐in by dairy farmers regarding their intention to vaccinate against LSD (dataset 2). The intersection between these datasets yielded 56 questionnaires, for which we had data on voluntary vaccination (Data‐intersect 1). These 56 questionnaire included 38 questionnaires filled‐in by farmers who intended to vaccinate against LSD in the coming year. Half of these 38 farmers vaccinate their herds in 2019, while the other half did not. Dataset 2 was divided to 57 questionnaires which were filled‐in before the 2019 epidemic and 33 after
FIGURE 2
FIGURE 2
Outline of vaccination strategy and LSD epidemic in Israel between 2012 and 2021. Green – periods of voluntary vaccination. Red – mandatory vaccination. The questionnaire study groups and the study rational are depicted by the rectangles in the bottom of the figure. The ‘after group’ represents questionnaires filled during and after the epidemic onset in 2019. The rational is that the ‘after group’ counterfactually represents the situation immediately after ceasing mandatory vaccination in June 2016.
FIGURE 3
FIGURE 3
The annual percentage of vaccination for lumpy skin disease (LSD) among 566 Israeli dairy farmers during years 2016–2019. The blue line represents the percentage of policyholders who vaccinated during January‐December, except for 2019 (during which vaccination became mandatory in June). The orange line represents percentage of policy‐holders who vaccinated only during January–May in each year.
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