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Issues Associated with Acceptability of Viral STD Vaccines Susan L. Rosenthal, Ph.D.

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Presentation on theme: "Issues Associated with Acceptability of Viral STD Vaccines Susan L. Rosenthal, Ph.D."— Presentation transcript:

1 Issues Associated with Acceptability of Viral STD Vaccines Susan L. Rosenthal, Ph.D

2 Overview  Theoretical models of health behaviors  Influences on attitudes  Characteristics of the vaccines  Review of studies using health belief models  Future research questions

3 Theoretical Model of Health Behaviors

4 Important Health Beliefs  Perceived severity  Perceived susceptibility  Barriers to implementing the behavior  Important others’ beliefs

5 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?)

6 Health Beliefs  Barriers to Implementing the Behavior – Access – Need for shots – Concerns about real or imagined side effects  Beliefs of Important Others – Normative beliefs – Motivation to comply with preferences of relevant others

7 Influences on Attitudes

8 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

9 Mrs. Smith, now that your daughter is 13, it’s time for her to get vaccinated for gonorrhea, chlamydia, and herpes Zimet, 2000

10 Societal/Cultural Beliefs  Beliefs about immunization in general  Risk behavior and STDs

11 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”

12 Psychosocial/Behavioral Factors and Vaccine Effectiveness Vaccine Accepted Disease Incidence Decreased? False Reassurance re: Target STD False Reassurance re: Other STD Increased Risk Behaviors Zimet, 2000

13 Characteristics of the Vaccine

14 Vaccine Characteristics  Method of delivery – Shot – Frequency  Efficacy  Cost

15 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

16 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

17 Predictors of Vaccine Acceptance

18 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

19 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

20 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

21 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

22 Chain of Vaccine Acceptance Professional Organizations’ Recommendations  Health Care Providers  Parents  Adolescents  STD Vaccine Acceptance

23 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

24 Issues for Future Research

25  Efficacy – Level at which acceptance decreases – People’s understanding of partial efficacy – Physicians response in terms of recommendations

26 Issues for Future Research  Access/provider issues – Enhancing access – Cost to patient – Increasing provider comfort  Universal recommendation – Developing policy to accomplish

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