Building Successful COVID-19 Interventions: Increasing Vaccination Participation in the Netherlands

Abstract

Background Development of a safe and effective vaccine is not enough to mitigate the ongoing COVID-19 pandemic. The public must also be willing to vaccinate. To overcome the multiphased problem of vaccine hesitancy and achieve adequate vaccine coverage requires well-structured and targeted vaccine interventions. It is important to gain insight into the design process used to set up COVID-19 vaccination interventions to help answer the question of how to successfully develop interventions to increase vaccination participation. This study identified the vaccination interventions executed in the Netherlands and investigated the theoretical framework and design process used to plan these interventions.

Methods A mixed-methods study comprising of two phases was performed in the Netherlands. Phase 1 involved a document analysis of 27 documents provided by the Ministry of Health, Welfare, and Sport and RIVM to develop a matrix of executed COVID-19 vaccination interventions. Phase 2 entailed qualitative, semi-structured interviews with 8 identified experts that have experience implementing, devising, and/or inventorying the national and local COVID-19 vaccine interventions. Purposive sampling was used to represent the various regions of the country. The interviews verified the interventions in the matrix and added insight into how and why these interventions were set up.

Results Findings illustrated a lack of information and evidence of a theoretical framework used during the pre-planning of vaccination interventions in the Netherlands. The Theory of Change (ToC) approach is a powerful tool that can help successfully design interventions to improve vaccination uptake.

Conclusion This research adds to the growing recognition of the vital role a systematic design theory such as the Theory of Change (ToC) plays in significantly increasing the positive effects of vaccine interventions. Reporting on the ToC on the executed and future vaccine interventions will be the subject of future work.