Issues Associated with Acceptability of Viral STD Vaccines
description
Transcript of Issues Associated with Acceptability of Viral STD Vaccines
Issues Associated with Acceptability of Viral STD Vaccines
Susan L. Rosenthal, Ph.D
Overview
Theoretical models of health behaviors Influences on attitudesCharacteristics of the vaccines Review of studies using health belief
modelsFuture research questions
Theoretical Model of Health Behaviors
Important Health Beliefs
Perceived severityPerceived susceptibility Barriers to implementing the behavior Important others’ beliefs
Health Beliefs
Perceived Severity– Seriousness of the disease– Consequences of the disease
Perceived Susceptibility – Risk of acquiring the disease– Expectation that behavior would reduce the
likelihood of harm(What will be the impact of partial efficacy?)
Health Beliefs
Barriers to Implementing the Behavior – Access– Need for shots– Concerns about real or imagined side
effectsBeliefs of Important Others
– Normative beliefs– Motivation to comply with preferences of
relevant others
Influences on Attitudes
Health Care Providers
Health Care Providers– Comfort with talking about sexuality– Knowledge about disease– Knowledge about side effects – Expectations about parental attitudes and
need for consent
Mrs. Smith, now that your daughter is 13, it’s time for her to get vaccinatedfor gonorrhea, chlamydia, and herpes
Zimet, 2000
Societal/Cultural Beliefs
Beliefs about immunization in generalRisk behavior and STDs
Societal/Cultural Beliefs
National Vaccine Injury Compensation Program– “If you believe that you or a loved one has been
injured as a result of a vaccination, we may be able to help.“
The National Vaccine Information Center – “NVIC is dedicated to the prevention of vaccine
injuries and deaths through public education”
Psychosocial/Behavioral Factors and Vaccine Effectiveness
VaccineAccepted
DiseaseIncidenceDecreased?
False Reassurancere: Target STD
FalseReassurancere: Other STDIncreased
RiskBehaviors
Zimet, 2000
Characteristics of the Vaccine
Vaccine Characteristics
Method of delivery– Shot– Frequency
EfficacyCost
HPV Vaccine Characteristics
Characteristics of the vaccine:– Cost (150, 50, free)– Efficacy (50% or 90%)– Disease targeted (genital warts, cervical cancer,
both)
– Physician recommended Results for adolescents and young women:
– Most acceptable: 90% efficacy, physician recommended, and moderately priced
– Disease target made no difference
Zimet, et al, 2000
HPV/HSV Vaccine Acceptability Among College Students
Provided reproductive, sexual, and combined cues in description of the vaccine
Cue did not predict acceptance and there was no gender/cue interaction.
Boehner, et al, 2002
Predictors of Vaccine Acceptance
HBV Immunization Among Adolescents
Predictors for adolescents’ acceptance– Perception that immunization was important to
parents
– Belief that it is important for everyone to be vaccinated
Predictors for parents’ acceptance– Perception that immunization was important to
provider
– Concern about adolescent’s risk for HBV
Rosenthal, et al, 1995
HIV Vaccine Acceptability in Adolescents
Generic HIV vaccine acceptable– Mean 5.12 out of 6
Greater vaccine acceptability associated with:– Susceptibility to HIV– Benefits of being vaccinated
Lower vaccine acceptability– Fear of vaccine causing HIV– Not being a member of risk group– Fear of needles
Zimet, et al, 1999 and Webb, et al, 1999
Herpes Vaccine Acceptability in College Students
Number (%) accepting the vaccine – 207 (40% ) would get vaccine– 211 (41%) not sure– 100 (19%) would not
Greater likelihood of acceptance – Low cost– Belief that it would work (for yes/not sure)– All teens – All sexually experienced individuals (yes/no)
Rosenthal, et al., 1999
Other Findings
Different predictors of vaccine acceptance for HPV and HSV vaccine acceptance among college students
For vaccine trial participants, acceptance of HSV vaccine was related to decreased exercise and lower alcohol use
For vaccine trial participants, acceptance of HPV vaccine was influenced by perceptions of support from church/synagogue
Chain of Vaccine Acceptance
Professional Organizations’ Recommendations
Health Care Providers
Parents
Adolescents
STD Vaccine Acceptance
Summary of STD Vaccine Acceptability Studies
Positive attitudes about STD vaccines across populations
Vaccine efficacy is important, but probably not disease targeted
Acceptability associated with positive and negative health beliefs, but less so with health behaviors
Issues for Future Research
Issues for Future Research
Efficacy– Level at which acceptance decreases – People’s understanding of partial efficacy– Physicians response in terms of
recommendations
Issues for Future Research
Access/provider issues – Enhancing access– Cost to patient – Increasing provider comfort
Universal recommendation – Developing policy to accomplish