The key role of communication in the COVID-19 vaccination policy in the Netherlands: Findings from an expert interview study

In April 2021, the Grand Chamber of the European Court of Human Rights ruled that mandatory vaccination for well-known children’s diseases was compatible with the right to private life ex article 8 of the European Convention on Human Rights in the landmark case Vavřička and Others v. the Czech Republic. According to the Court, member states enjoy a wide degree of discretion in determining whether the protection of both individual and public health require mandatory vaccination. Simultaneously, the Court accentuates that mandatory vaccination schemes need to be in accordance with the law and can only be utilised if this is necessary in a democratic society, for instance to protect (public) health. The legitimacy of mandatory vaccination thus greatly depends on the question whether the mandatory vaccination scheme is proportionate or not. In particular, the Court emphasises the importance of the safety and effectiveness of vaccines. Hence, the judgment led to questions regarding the possibilities for mandatory COVID-19 vaccination in Europe.

In the Netherlands there is currently no law that obligates people to get vaccinated. However, in the past, fluctuations in the vaccination coverage against infectious diseases, such as measles, have led to societal and political debates concerning the degree of directiveness the Dutch vaccination policy should have. The outbreak of the coronavirus – and the development of a vaccine subsequently – has intensified this debate particularly. Although currently, around 81% of the Dutch population (aged 12 years or older) has had both the first and second vaccination against COVID-19, reports show that fewer people are willing to receive booster and repeat vaccinations.

This interview study aims to obtain a wide range of multidisciplinary views regarding the desirable degree of directiveness in the Dutch vaccination policy. We therefore conducted 16 semi-structured interviews with legal, medical and ethical experts in the field of public health and vaccination policy(-making). Hereafter, we used the conventional content analysis method to inductively analyse collected data. Our study focuses both on vaccination against COVID-19 and other infectious diseases. However, in this presentation we will share our results relating to COVID-19 vaccination. Several topics and themes were discussed during the interviews, amongst which: the use of current and potential interventions in the COVID-19 vaccination policy, the desirability of a more directive vaccination policy and the evaluation of conditions in which such a policy should be set up.

Our research shows that most experts prefer using targeted communication and information rather than using pressure or coercion in the COVID-19 vaccination policy. However, the way in which communication as intervention is currently used, needs to be amended. This is especially relevant for reaching certain target groups. Besides, involving (trusted) individuals of these target groups can be helpful in finding effective ways to inform and communicate about COVID-19 vaccination. We have also discussed in which situations other, more freedom restrictive, interventions can be considered. Our results lead to new viewpoints regarding the use of communication in the COVID-19 vaccination policy and indicate that this intervention keeps playing a key role therein.