Institut Pasteur, Université Paris Cité, Emerging Disease Epidemiology Unit, 75015, Paris, France.
Université Paris Cité, LIRAES, 75006, Paris, France.
Patient. 2024 Sep;17(5):575-588. doi: 10.1007/s40271-024-00687-6. Epub 2024 May 1.
With the aim to optimize communication during HPV vaccination campaigns in France, we elicited parental preferences around HPV vaccination.
We conducted a single-profile discrete choice experiment (DCE) among parents of 11- to 14-year-old middle-school pupils, who completed an anonymous, self-administered, internet-based questionnaire during 2020-2021. The DCE comprised five attributes (vaccine-preventable disease, justification of optimal age, information on safety, indirect protection and coverage) of vaccination against an unnamed disease that were presented to respondents in ten choice tasks, or scenarios. We use fixed effect logit models to estimate attribute weights on theoretical vaccine acceptance, and random effect linear regression to estimate attribute coefficients on vaccine eagerness (decision and decision certainty). We estimated marginal effects of attributes on expected vaccine acceptance.
Vaccination scenarios were accepted by 55.6-89.2% of the 1291 participants. The largest marginal effects on expected vaccine acceptance in the full sample arose from prevention of cancer versus genital warts (+ 11.3 percentage points); from a "severe side effect suspicion that was not scientifically confirmed" versus a statement about "more benefits than risks" (+ 8.9 percentage points), and information on 80% vaccine coverage in neighbouring countries versus on "insufficient coverage" (+ 4.2 percentage points). Explaining the early age of vaccination by sexual debut had a strong negative impact among French monolingual parents with lower education level (vs age-independent, OR 0.48, 95% CI 0.27-0.86), but not other socio-economic groups. After removing low-quality responses (unvaried certainty and short questionnaire completion), among serial non-demanders with children not vaccinated against HPV, only disease elimination impacted vaccine eagerness positively (coefficient 0.54, 0.06-1.02).
Using DCEs to elicit parents' preferences around communication messages, notably on cancer prevention, vaccine coverage and information about vaccine safety, could help to optimize HPV vaccination promotion efforts.
为了优化法国 HPV 疫苗接种活动中的沟通，我们了解了父母对 HPV 疫苗接种的偏好。
我们在 2020 年至 2021 年间，对 11 至 14 岁中学生的父母进行了一项单轮廓离散选择实验（DCE）。DCE 包括针对一种未命名疾病的疫苗接种的五个属性（可预防疾病、最佳年龄的理由、安全性信息、间接保护和覆盖率），这些属性在十个选择任务或场景中呈现给受访者。我们使用固定效应逻辑回归模型来估计理论疫苗接受度的属性权重，并使用随机效应线性回归来估计疫苗渴望度（决策和决策确定性）的属性系数。我们估计了属性对预期疫苗接受度的边际效应。
在 1291 名参与者中，有 55.6-89.2%的人接受了疫苗接种方案。在全样本中，对预期疫苗接受度影响最大的边际效应来自预防癌症与生殖器疣（+11.3 个百分点）；从“疑似严重副作用但未经科学证实”与“好处多于风险”的声明（+8.9 个百分点），以及邻国 80%疫苗覆盖率的信息与“覆盖率不足”（+4.2 个百分点）。在法国讲单一语言且受教育程度较低的父母中，将疫苗接种年龄提前到性成熟与年龄无关的解释相比，有很大的负面影响（比值比 0.48，95%置信区间 0.27-0.86），但在其他社会经济群体中则没有。在剔除低质量的回答（不确定度不变和问卷完成时间短）后，在连续的非需求者中，那些孩子未接种 HPV 疫苗的人中，只有消除疾病会对疫苗渴望产生积极影响（系数 0.54，0.06-1.02）。
使用 DCE 来了解父母对沟通信息的偏好，特别是对癌症预防、疫苗覆盖率和疫苗安全性信息的偏好，可能有助于优化 HPV 疫苗推广工作。
