Vaccine Communication

Transcription

1 Vaccine Communication Noel T. Brewer, PhD Associate Professor of Health Behavior, UNC Chair, National HPV Vaccination Roundtable

2 Disclosures Grants, advisory boards or paid speaker American Cancer Society Centers for Disease Control and Prevention Federal Drug Administration GlaxoSmithKline Merck National Cancer Institute Pfizer Robert Wood Johnson Foundation

3 What went wrong HPV vaccine communication?

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6 Adolescent vaccine coverage, U.S. Adolescents ages % Vaccinated Healthy People 2020 Goal Year Tdap Meningococcal HPV (3 doses, females) HPV (3 doses, males) Data from National Immunization Survey-Teen

7 Industry 83% of parents of adolescent girls heard of HPV vaccine from a drug company ad n=889, Hughes, Brewer, et al., 2009, CEBP

8 Source Merck Gardasil CDC ACS [none] Industry

9 Industry 62% thought non-profits ads were from a drug company n=544, Pepper et al., STI

10 Industry 62% thought non-profits ads were from a drug company Source (drug co.) -.21* -.16* Trust.31* Liking.46* Motivation to vaccinate n=544, Pepper et al., STI

11 HPV Vaccination-Mandate Bills and Orders in the States, Legislation Colgrove et al., 2010, NEJM

12 Brewer & Gilkey, JAMA School entry requirements Modest support 44% (25%-62%) 8 studies (n=4,811) High support w/opt-out 84% (64%-92%) 3 studies (n=1,423) CA, MA, NC

13 Impact of school requirements Embargoed data redacted: Analyses examined the impact of school entry requirements on HPV vaccination Moss, et al., under review

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15 Sexual disinhibition No studies show SD. Few parents believe in it: 10% (3-26%). 8 studies, n=4,597 This belief is a result of vaccination, not a predictor of it Brewer et al. 2011; Schuler et al. 2011

16 Retardation Well, I will tell you that I had a mother last night come up to me here in Tampa, Florida, after the debate. She told me her little daughter took that -- took that vaccine, that injection, and she suffered from mental retardation thereafter. It can have very dangerous side effects. The mother was crying when she came up to me last night. I didn't know who she was before the debate. This is the very real concern. And people have to draw their own conclusions. Michelle Bachman, 9/13/11, NBC's "Today" show

17 Retardation Heard p=.005 Time p<.001 HxT p<.001 n=326 n=327, Zucker et al., 2015

18 Anti-vaccination sentiment Nittinger, Twitter, 2016.

19 YouTube

20 Tweets on HPV Vaccine 30,621 users made 83,551 tweets that reached 51,397,377 followers Dunn, et al., 2015

21 Clustering Vaccine hesitant parents cluster Geographically In social media Dunn, et al., 2015

22 Confidence continuum Cooper-Robbins et al., 2010

23 How do we increase confidence?

24 HCPs Parents with a healthcare provider s recommendation much more likely to vaccinate Only 10% of parents had received a provider s recommendation 7 studies; n=18,955 OR=18 (range ) n=327, Reiter et al., 2013, AJPH

25 Introducing vaccines Accepted vaccine Announcement It s time for shots. 90% Optional What do you want to do about shots? 17% n=111, Opel, et al., 2015

26 Introducing vaccines Embargoed data redacted: Analyses examined the impact of participatory and efficient physician-patient communication styles on HPV vaccination coverage n=9,021, NIS-Teen, Moss, et al., in press

27 Addressing parent concerns Ask, Advise, Acknowledge Henricksen et al., 2015, Peds CASE (Corroborate, About me, Science, Explain/advise) Singer EASE Elicit main concern Acknowledge Share your commitment Explain the research Brewer et al., unpublished

28 Motivational statements Embargoed data redacted: Analyses examined how well motivational statements motivated parents to want to get HPV Vaccination for their adolescent children

29 Summary Clinician communication Early, always, high-quality Brief Respected organizations taking charge of communication Social media

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31 Contact information Noel Brewer UNC Gillings School of Global Public Health HPV research:

32 References Brewer, N. T., Gottlieb, S. L., Reiter, P. L., McRee, A. L., Liddon, N., Markowitz, L. E., & Smith, J. S. (2011). Longitudinal predictors of HPV vaccine initiation among adolescent girls in a high-risk geographic area. Sexually Transmitted Diseases, 38, Fischhoff, B. (2012). Communicating risks and benefits: An evidence based user's guide. Government Printing Office. Gilkey, M. B., & Brewer, N. T. (2012). Mandatory HPV vaccination. [peer-reviewed letter] JAMA, 307, PMID: Hughes, J. H., Cates, J. R., Liddon, N., Smith, J. S., Gottlieb, S. L., & Brewer, N. T. (2009). Disparities in how parents are learning about the human papillomavirus vaccine. Cancer Epidemiology, Biomarkers & Prevention, 18, PMID: Pepper J. K., Reiter, P. L., McRee, A. L., & Brewer, N. T. (2012). Advertisements promoting HPV vaccine for adolescent males: Does source matter? Sexually Transmitted Infections, 88, PMID: Reiter, P. L., McRee, A. L., Pepper, J. K., Gilkey, M. B., Galbraith, K. V., & Brewer, N. T. (2013). Longitudinal predictors of HPV vaccination among a national sample of adolescent males. American Journal of Public Health, 103, PMID: Schuler, C. L., Reiter, P. L., Smith, J. S., & Brewer, N. T. (2011). Human papillomavirus vaccine and behavioral disinhibition. Sexually Transmitted Infections, 87, Zucker, R. A., Reiter, P. L., Mayer, M. K., & Brewer, N. T. (2015). Effects of a presidential candidate s comments on HPV vaccine. Journal of Health Communication, 20, PMID:

33 References Colgrove, J., Abiola, S., & Mello, M. M. (2010). HPV vaccination mandates lawmaking amid political and scientific controversy. New England Journal of Medicine, 363(8), Dunn, A. G., Leask, J., Zhou, X., Mandl, K. D., & Coiera, E. (2015). Associations Between Exposure to and Expression of Negative Opinions About Human Papillomavirus Vaccines on Social Media: An Observational Study. Journal of Medical Internet Research, 17(6). Henrikson, N. B., Opel, D. J., Grothaus, L., Nelson, J., Scrol, A., Dunn, J.,... & Grossman, D. C. (2015). Physician communication training and parental vaccine hesitancy: A randomized trial. Pediatrics, 136(1), National Immunization Survey Teen, Opel, D. J., Mangione-Smith, R., Robinson, J. D., Heritage, J., DeVere, V., Salas, H. S.,... & Taylor, J. A. (2015). The influence of provider communication behaviors on parental vaccine acceptance and visit experience. American Journal of Public Health, 105(10), Cooper Robbins, S. C., Bernard, D., McCaffery, K., Brotherton, J. M., & Skinner, S. R. (2010). I just signed : Factors influencing decision-making for school-based HPV vaccination of adolescent girls. Health Psychology, 29(6), 618.