Risk perception, risk management and safety assessment: What can governments do to increase public confidence in their vaccine system?

Dalhousie University, Canadian Center for Vaccinology, IWK Health Center, 5850/5980 University Ave, Halifax, Nova Scotia, Canada B3K 6R8.
Biologicals (Impact Factor: 1.21). 10/2011; 40(5):384-8. DOI: 10.1016/j.biologicals.2011.08.001
Source: PubMed


For decades vaccine program managers and governments have devoted many resources to addressing public vaccine concerns, vaccine risk perception, risk management and safety assessment. Despite ever growing evidence that vaccines are safe and effective, public concerns continue. Education and evidence based scientific messages have not ended concerns. How can governments and programs more effectively address the public's vaccine concerns and increase confidence in the vaccine safety system? Vaccination hesitation has been attributed to concerns about vaccine safety, perceptions of high vaccine risks and low disease risk and consequences. Even when the public believes vaccines are important for protection many still have concerns about vaccine safety. This overview explores how heuristics affect public perception of vaccines and vaccine safety, how the public finds and uses vaccine information, and then proposes strategies for changes in the approach to vaccine safety communications. Facts and evidence confirming the safety of vaccines are not enough. Vaccine beliefs and behaviours must be shaped. This will require a shift in the what, when, how and why of vaccine risk and benefit communication content and practice. A change to a behavioural change strategy such as the WHO COMBI program that has been applied to disease eradication efforts is suggested.

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    • "The websites were systematically examined on 12 website comparison elements. This list was used to further comment on the content of each field relying on risk communication notions (Fitzpatrick-Lewis et al. 2010; Gore and Bracken 2005; Huang et al. 2013; Kievik and Gutteling 2011; Kievik, ter Huurne, and Gutteling 2012; MacDonald, Smith, and Appleton 2012; Miceli, Sotgiu, and Settanni 2007; Ter Huurne and Gutteling 2008, 2009; Verroen, Gutteling, and De Vries 2013; Witte and Allen 2000). All observations were gathered in an Excel table. "
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    ABSTRACT: This study aims at analyzing differences between risk communication policies in Cyprus, compared to the Netherlands, and France. It analyzes risk communication policies indirectly through a qualitative analysis of the information provided by official websites, which are considered to be proxies of these policies. The websites review will focus on the type of the information disclosed online, and the similarities and differences between the websites, regarding the information provided, the way it is communicated, the backing on credible sources, and the supplying of more information if desired, but also simply through the presenting of the WebPages. The results indicate that the Netherlands and France have created risk dedicated websites besides the ministries’ websites with information on risks, prevention and the authorities’ actions. There is a gap between strategies. The Dutch strategy is to give more responsibilities to the public, by encouraging individuals to be resilient and responsible for their own safety at a certain level by promoting preventive behaviors. The French strategy is to provide riskdedicated information to the public, also on prevention and government actions. Opposed to this, the Cypriot authorities simply avoid this strategic question by confining the risk communication to the crisis phase, without entrusting people with a role in risk management, and by strictly one-directional communication, with government delivering and the public digesting (or not). Suggestions for risk communication policy development are discussed.
    Journal of Risk Research 10/2015; Online first. DOI:10.1080/13669877.2015.1100656 · 1.27 Impact Factor
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    • "JVAC-16371; No. of Pages 8 G.J. Nowak et al. / Vaccine xxx (2015) xxx–xxx 3 the population, and the factors influencing hesitation are not the same across the subgroups [21] [22]. Some subgroups may be more difficult to address or persuade [8] [14] and therefore knowing how subgroups differ from each other is essential. Context timing and vaccine also matter. "
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    ABSTRACT: Many countries and communities are dealing with groups and growing numbers of individuals who are delaying or refusing recommended vaccinations for themselves or their children. This has created a need for immunization programs to find approaches and strategies to address vaccine hesitancy. An important source of useful approaches and strategies is found in the frameworks, practices, and principles used by commercial and social marketers, many of which have been used by immunization programs. This review examines how social and commercial marketing principles and practices can be used to help address vaccine hesitancy. It provides an introduction to key marketing and social marketing concepts, identifies some of the major challenges to applying commercial and social marketing approaches to immunization programs, illustrates how immunization advocates and programs can use marketing and social marketing approaches to address vaccine hesitancy, and identifies some of the lessons that commercial and non-immunization sectors have learned that may have relevance for immunization. While the use of commercial and social marketing practices and principles does not guarantee success, the evidence, lessons learned, and applications to date indicate that they have considerable value in fostering vaccine acceptance. Copyright © 2015. Published by Elsevier Ltd.
    Vaccine 04/2015; 32(34). DOI:10.1016/j.vaccine.2015.04.039 · 3.62 Impact Factor
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    • "Preclinical evaluation of such viral vector vaccines has indicated their potential for immunization and an increasing number of candidate vaccines are entering human clinical trials. Improving our ability to anticipate potential safety issues and meaningfully assess or interpret safety data from trials of such new viral vector vaccines will increase the likelihood of public acceptance should they be licensed [10] [11] [12] [13]. The Brighton Collaboration ( was formed in 2000 as an international voluntary collaboration to enhance the science of vaccine safety research [e.g., via development of standardized case definitions of adverse events following immunizations (AEFI)] [14]. "
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    ABSTRACT: The Brighton Collaboration Viral Vector Vaccines Safety Working Group (V3SWG) was formed to evaluate the safety of live, recombinant viral vaccines incorporating genes from heterologous viruses inserted into the backbone of another virus (so-called "chimeric virus vaccines"). Many viral vector vaccines are in advanced clinical trials. The first such vaccine to be approved for marketing (to date in Australia, Thailand, Malaysia, and the Philippines) is a vaccine against the flavivirus, Japanese encephalitis (JE), which employs a licensed vaccine (yellow fever 17D) as a vector. In this vaccine, two envelope proteins (prM-E) of YF 17D virus were exchanged for the corresponding genes of JE virus, with additional attenuating mutations incorporated into the JE gene inserts. Similar vaccines have been constructed by inserting prM-E genes of dengue and West Nile into YF 17D virus and are in late stage clinical studies. The dengue vaccine is, however, more complex in that it requires a mixture of four live vectors each expressing one of the four dengue serotypes. This vaccine has been evaluated in multiple clinical trials. No significant safety concerns have been found. The Phase 3 trials met their endpoints in terms of overall reduction of confirmed dengue fever, and, most importantly a significant reduction in severe dengue and hospitalization due to dengue. However, based on results that have been published so far, efficacy in preventing serotype 2 infection is less than that for the other three serotypes. In the development of these chimeric vaccines, an important series of comparative studies of safety and efficacy were made using the parental YF 17D vaccine virus as a benchmark. In this paper, we use a standardized template describing the key characteristics of the novel flavivirus vaccine vectors, in comparison to the parental YF 17D vaccine. The template facilitates scientific discourse among key stakeholders by increasing the transparency and comparability of information. The Brighton Collaboration V3SWG template may also be useful as a guide to the evaluation of other recombinant viral vector vaccines. Copyright © 2014. Published by Elsevier Ltd.
    Vaccine 10/2014; 33(1). DOI:10.1016/j.vaccine.2014.10.004 · 3.62 Impact Factor
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