Biomedical Engineering Reference
In-Depth Information
the future motivation to vaccinate. Prevalence-elasticity can explain why in many
high-income countries childhood diseases which were virtually eradicated, thanks
to a very high pediatric vaccination rate, were followed by a decline in pediatric
vaccination rates, which has led to a resurgence of childhood diseases. For example,
measles is reemerging in Europe, with 85 % of the cases being unvaccinated.
11
In France, which accounts for more than half of the reported cases in 2011, the
upsurge is attributed to a decline in the vaccination rate (Benkimoun
2011
). Funk
et al. (
2010
) review a number of models for explaining the dynamics of the disease
prevalence-prevention behavior relationship.
Consumer beliefs about risk factors related to individual characteristics can also
affect the perceived likelihood of getting a disease (personal vulnerability/suscepti-
bility) and, therefore, the motivation for vaccination. For example, young women
with a greater number of sexual partners had a high level of interest in receiving an
HPV vaccine (Dekker
2006
). Parents who believed that their child was not engaged in
sexual activity and not at risk for HPV were less likely to endorse HPV vaccination or
opposed to it (Brown et al.
2010
). In Brewer et al.'s (
2007
) meta-analysis, perceived
likelihood and susceptibility (e.g., “I get sick more easily than other people my age”)
were signifi cant predictors of vaccination behavior.
The second factor contributing to the perceived threat from a disease is its
perceived severity. In a meta-analysis, perceived severity signifi cantly predicted
vaccination behavior (Brewer et al.
2007a
). In a conjoint analysis of vaccine
decision-making among mid-adult women, the severity of disease was one of the
two main drivers for vaccine acceptability (Stockwell et al.
2011
). Poor parental
knowledge about the harmfulness of measles infection seemed to be responsible for
the low measles vaccination rates in Germany (Schönberger et al.
2009
).
The perceived likelihood and severity of a disease are cognitive judgments.
Rogers' protection motivation theory (Rogers
1975
,
1983
) also includes an affective
component with its “threat appraisal” construct, namely fear. Consistent with this
conceptualization, Chapman and Coups (
2006
) found that anticipated worry medi-
ated the effect of perceived risk on infl uenza vaccination, and Weinstein et al. (
2007
)
concluded that feeling at risk was a better predictor of vaccination behavior than
purely cognitive risk judgments.
Attitude Toward Vaccination
The attitude toward vaccination is a key construct in all theoretical frameworks.
The attitude object can be vaccination in general, types of vaccines (e.g., pediatric
vaccines), or vaccines against a specifi c disease (e.g., fl u vaccines).
Keane et al. (
2005
) clustered parents into four vaccination attitude and belief
segments, which differed in vaccination rates: vaccine believers (33 %), cautious
August 31.
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