Martinón-Torres Federico, de Miguel Ángel Gil, Ruiz-Contreras Jesús, Vallejo-Aparicio Laura A, García Andrea, Gonzalez-Inchausti María C, de Gomensoro Eduardo, Kocaata Zeki, Gabás-Rivera Clara, Comellas Marta, Prades Miriam, Lizán Luis
Translational Pediatrics and Infectious Diseases, Pediatrics Department, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain.
Genetics, Vaccines and Infections Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago, University of Santiago de Compostela, Santiago de Compostela, Spain.
Infect Dis Ther. 2023 Jan;12(1):157-175. doi: 10.1007/s40121-022-00708-7. Epub 2022 Nov 11.
Immunization is the most effective strategy for the prevention of invasive meningococcal disease caused by Neisseria meningitidis serogroup B (MenB); however, parents need to weigh the risk-benefit and financial impact of immunizing their children against MenB in the absence of a national immunization program (NIP). This study aimed to explore societal preferences (of parents and pediatricians) regarding the attributes of a MenB vaccine in Spain.
A discrete choice experiment (DCE) based on cross-sectional surveys was carried out to determine preferences. A literature review and scientific committee determined the six attributes related to the MenB vaccine included in the DCE: vaccination age, cost, duration, percentage of protection, adverse events probability, and expert/authority recommendation. Data were analyzed using a mixed logit model. Relative importance (RI) of attributes was calculated and compared between parents and pediatricians.
A total of 278 parents [55.8% female, mean age 40.4 (standard deviation, SD 7.3) years] and 200 pediatricians [73.0% female, mean age 45.8 (SD 12.9) years] answered the DCE. For parents, the highest RI was attributed to vaccine cost, expert/authority recommendation, and percentage of protection (26.4%, 26.1%, and 22.9%, respectively), while for pediatricians the highest RI was assigned to percentage of protection, expert/authority recommendation, and vaccination age (27.2%, 23.7%, and 22.6%, respectively). Significant differences between parents and pediatricians were found in the RI assigned to all attributes (p < 0.001), except for vaccine recommendation.
In the decision regarding MenB vaccination, cost was a driver in parental decision-making but had a low RI for pediatricians and, conversely, vaccination age was highly valued by pediatricians but was the attribute with least importance for parents. Despite these differences, expert/authority recommendation and percentage of protection were essential criteria for both groups. These results provide relevant information about MenB vaccination, highlighting the importance of considering societal preferences for NIP inclusion.
免疫接种是预防由B群脑膜炎奈瑟菌（MenB）引起的侵袭性脑膜炎球菌病的最有效策略；然而，在没有国家免疫规划（NIP）的情况下，家长需要权衡为孩子接种MenB疫苗的风险效益和经济影响。本研究旨在探讨西班牙社会（家长和儿科医生）对MenB疫苗属性的偏好。
基于横断面调查开展了一项离散选择实验（DCE）以确定偏好。文献综述和科学委员会确定了DCE中与MenB疫苗相关的六个属性：接种年龄、成本、持续时间、保护百分比、不良事件概率以及专家/权威推荐。使用混合逻辑模型对数据进行分析。计算并比较了家长和儿科医生之间属性的相对重要性（RI）。
共有278名家长[女性占55.8%，平均年龄40.4（标准差，SD 7.3）岁]和200名儿科医生[女性占73.0%，平均年龄45.8（SD 12.9）岁]回答了DCE。对于家长而言，最高的RI归因于疫苗成本、专家/权威推荐和保护百分比（分别为26.4%、26.1%和22.9%），而对于儿科医生来说，最高的RI归因于保护百分比、专家/权威推荐和接种年龄（分别为27.2%、23.7%和22.6%）。除了疫苗推荐外，在所有属性的RI分配上，家长和儿科医生之间均存在显著差异（p < 0.001）。
在MenB疫苗接种决策中，成本是家长决策的一个驱动因素，但对儿科医生来说RI较低，相反，接种年龄受到儿科医生的高度重视，但对家长来说是最不重要的属性。尽管存在这些差异，但专家/权威推荐和保护百分比对两组而言都是重要标准。这些结果提供了有关MenB疫苗接种的相关信息，突出了在NIP纳入中考虑社会偏好的重要性。
