Vaccine Marketing - Innovation and Marketing in the Pharmaceutical Industry - page 379

Consumer-Related Concerns
One reason why physicians do not always recommend vaccination to all eligible
consumers is that especially during illness visits urgent consumer concerns domi-
nate (Szilagyi et al. 2005 ). Another reason may be that physicians segment consum-
ers on the basis of their perceived vulnerability/susceptibility. Zimet et al. ( 2011 )
found that physicians gave higher priority for HPV vaccination to women who were
single and dating or not dating than to women who were married or in a long-term
monogamous relationship, with relationship status functioning as an indicator of the
risk for HPV infection.
Some physicians see themselves as proactive advocates for vaccination and others as
reactors to consumer requests. Seventy-two percent of high HPV vaccination discussion
initiators in Asia agreed with the statement “It is my role to proactively provide advice
on preventive health measures to my female patients” compared with 45 % of low initia-
tors (Chow et al. 2010 ). Eighty percent of US pediatricians who recommended the HPV
vaccine to all eligible patients agreed with the statement “I will recommend the vaccine
and try to persuade those who are reluctant” compared with 38 % of physicians who
recommended the vaccine to some/none of patients (Ishibashi et al. 2008 ). One barrier
to advocating vaccination especially when it involves signifi cant out-of-pocket payment
is that physicians fear to be seen as “hard-selling an expensive vaccine” (Chow et al.
2010 ), or as “just trying to give my kid another shot” (Humiston et al. 2009 ).
Physicians' vaccination advocacy also depends on their perceived self-effi cacy for
engaging in vaccination discussions, and actually bringing about the desired con-
sumer behavior. Among the physicians who were high HPV discussion initiators,
76 % felt “Quite comfortable/very comfortable initiating and conducting conversa-
tions with parents about HPV vaccinations,” and 51 % felt that “a recommendation by
their doctor will improve the likelihood of a mother getting her daughter vaccinated”
compared with 53 % and 36 %, respectively, among the low discussion initiators
(Chow et al. 2010 ). Daley et al. ( 2006 , 2010 ) found that the perceived need to discuss
sexuality prior to recommending HPV vaccine, and the belief that parents of 11- to
12-year-olds would be more likely to refuse than parents of 16- to 18-year-olds were
associated with a lower likelihood and strength of recommending HPV vaccine to
11- to 12-year-old female patients.
Financial Concerns
Health care professionals are also concerned with the fi nancial outcomes of their
vaccination behaviors. The fee for vaccine administration may not adequately com-
pensate them for the time spent (Humiston et al. 2009 ).
Additional fi nancial concerns arise when physicians also dispense vaccines. In the
United States, most physicians dispense both vaccines which are purchased by the
government and private sector vaccines which are purchased by physicians in advance
of patient demand. The latter involve costs for ordering and managing the stock, invest-
ment in refrigerators (or freezers for some vaccines), and fi nancial risk (Shen et al.
2009b ). These fi nancial concerns can represent important barriers to physician