Biomedical Engineering Reference
In-Depth Information
Consumers are motivated to seek therapeutic treatment because they experience
a current health problem, whereas preventive vaccination requires that consumers
anticipate a future health problem. Marketers of preventive vaccines therefore must
ensure consumer awareness of the risks of infectious disease and motivate them to
take preventive action. This is particularly challenging when past vaccination cam-
paigns have virtually eradicated a vaccine target. Benefi cial outcomes from thera-
peutics are often easily observable because of the resulting improvement in health
status (e.g., pain reduction), whereas a successful preventive vaccination does not
improve the health status of the vaccinated person and can even sometimes deterio-
rate it due to adverse events. To perceive the benefi ts of prevention, individuals must
engage in counterfactual thinking (Roese
1997
), e.g., “If I had not gotten the fl u
shot, I would have caught the fl u.” While receiving less credit for benefi ts than
therapeutics, preventive vaccines are easily blamed when previously healthy per-
sons experience health problems which may be unrelated to the vaccination. Stories
of healthy people presumably made sick by vaccines are very attractive for the
media and may lead to an exaggerated perception of the risks of vaccination and
skepticism about its value among the lay public. Ensuring an accurate perception
of the benefi t-risk balance therefore represents another distinctive challenge for
marketers of preventive vaccines.
Many therapeutics are for chronic disease and involve daily or weekly use.
Consumers therefore have an opportunity to learn from direct experience and
develop intimacy with their treatment, which infl uences their decision to continue
or switch. Except for seasonal fl u vaccines, the vast majority of preventive vaccines
are administered only once or very infrequently during a life time (e.g., every 10 years
for tetanus booster shots). Personal use experience, therefore, plays no or a very
small role in preventive vaccine treatment decisions, which are based on other
sources of information such as health care professionals, advertisements, friends,
information on the internet, and other media Cates et al.
2010
; Kennedy et al.
2012
(Kennedy et al.
2011a
; Freed et al.
2011a
; Maurer et al.
2010a
,
b
).
Both therapeutics and preventive vaccines have a direct effect on the health of
treated individuals. Preventive vaccines in addition have an indirect “herd-
protective” effect by reducing interindividual transmission and thereby lowering
the risk of infection among unvaccinated persons (Smith
2010b
). For example, it
is estimated that a 50 % HPV vaccination rate of women will result in a 47 %
reduction in cervical cancer incidence, with one in four cases prevented among
non-vaccinated women (Bogaards et al.
2011
). When individuals do not take
these positive externalities into account, market failure may result, namely less vac-
cination than is effi cient from a societal point of view (Fine and Clarkson
1986
).
The possibility of market failure provides a rationale for governmental interven-
tions such as subsidies to consumers and mandatory vaccination. Mandatory vac-
cination, which is controversial because it restricts individual freedom in the
interest of collective benefi ts, is another differentiating feature of preventive vaccine
public markets.
Governments and supranational organizations play an even more central role
in the preventive vaccine market than for therapeutics. They often subsidize R&D
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