Lavelle Tara A, Messonnier Mark, Stokley Shannon, Kim David, Ramakrishnan Aparna, Gebremariam Achamyeleh, Simon Norma-Jean E, Rose Angela M, Prosser Lisa A
Center for the Evaluation of Value and Risk in Health (CEVR), Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, 800 Washington St, Boston, MA, 02111, USA.
National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA.
J Patient Rep Outcomes. 2019 Jul 29;3(1):51. doi: 10.1186/s41687-019-0135-0.
Adult and adolescent vaccination rates are far below coverage targets in the United States. Our objective was to identify the most influential factors related to vaccine uptake among adults, adolescents, and parents of adolescents (parents) in the United States.
We used a fractional factorial design to create a binary choice survey to evaluate preferences for vaccination. The national survey was fielded to a sample of adults, adolescents ages 13-17 years, and parents, using a national probability-based online research panel in November 2015. Respondents were presented with 5 profiles of a hypothetical vaccine and asked in a series of questions whether they would accept each vaccine. We analyzed the binary choice data using logistic regression in STATA v13 (College Station, TX) to calculate the odds that a participant would choose to accept the vaccine.
We received completed responses from 334 (51%) of 652 adults, 316 (21%) of 1516 adolescents, and 339 (33%) of 1030 parents. Respondents were generally representative of the U.S.
Vaccine effectiveness was the most influential factor in the choice to vaccinate for all groups. Other most influential factors were primary care provider (PCP) recommendation and the out-of-pocket cost of the vaccine. Other factors such as risk of illness, risk of vaccine side effects, vaccination location, and time for vaccination were not important in the decision to get vaccinated.
Adults, adolescents, and parents are most sensitive to vaccine effectiveness, PCP recommendation, and out-of-pocket cost for vaccination in their decision to get vaccinated. Strong PCP recommendations that focus on vaccine effectiveness and health care policies that minimize out-of-pocket costs for vaccinations may increase vaccine uptake by adults and adolescents.
在美国,成人和青少年的疫苗接种率远低于覆盖目标。我们的目标是确定在美国成年人、青少年以及青少年家长(父母)中与疫苗接种率最相关的影响因素。
我们采用分数析因设计创建了一项二元选择调查,以评估对疫苗接种的偏好。2015年11月,通过基于全国概率的在线研究小组,对成年人、13 - 17岁的青少年以及家长进行了全国性调查。向受访者展示了一种假设疫苗的5种情况,并通过一系列问题询问他们是否会接受每种疫苗。我们使用STATA v13(德克萨斯州大学站)中的逻辑回归分析二元选择数据,以计算参与者选择接受疫苗的几率。
我们收到了652名成年人中的334名(51%)、1516名青少年中的316名(21%)以及1030名家长中的339名(33%)的完整回复。受访者总体上代表了美国人口。
疫苗有效性是所有群体选择接种疫苗时最具影响力的因素。其他最具影响力的因素是初级保健提供者(PCP)的推荐以及疫苗的自付费用。其他因素,如患病风险、疫苗副作用风险、接种地点和接种时间,在决定是否接种疫苗时并不重要。
成年人、青少年和家长在决定是否接种疫苗时,对疫苗有效性、PCP推荐和疫苗接种的自付费用最为敏感。注重疫苗有效性的强烈PCP推荐以及将疫苗接种自付费用降至最低的医疗保健政策,可能会提高成年人和青少年的疫苗接种率。