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

ABSTRACT 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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    • "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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    • "The Brighton Collaboration was launched in 2000 to improve the science of vaccine safety [1] – an issue that had become increasingly controversial and prominent worldwide, particularly in countries with mature immunization programs which had nearly eliminated targeted vaccine-preventable diseases [2] [3] [4]. To provide a common vocabulary for vaccine safety researchers, the Brighton Collaboration focused its initial efforts on developing standardized case definitions for adverse events following immunizations (AEFI), including guidelines for data collection, analysis, and presentation [5]. "
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    ABSTRACT: Recombinant viral vectors provide an effective means for heterologous antigen expression in vivo and thus represent promising platforms for developing novel vaccines against human pathogens from Ebola to tuberculosis. An increasing number of candidate viral vector vaccines are entering human clinical trials. The Brighton Collaboration Viral Vector Vaccines Safety Working Group (V3SWG) was formed to improve our ability to anticipate potential safety issues and meaningfully assess or interpret safety data, thereby facilitating greater public acceptance when licensed.
    Vaccine 10/2014; 33(1). DOI:10.1016/j.vaccine.2014.09.035 · 3.62 Impact Factor
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