Over the past 150 years, innovations in immunization practices have dramatically improved the health of children, and parents are increasingly asked to consider and accept new childhood vaccines. We present a conceptual model to frame a review of research on the role of parental attitudes and beliefs in decision making about child and adolescent immunization and describe the historical context of vaccine-related decision-making research. This review focuses on theory-based Social-environmental and parent-specific personal factors as potential influences on vaccine decision making. Relevant Social-environmental issues discussed include media coverage of vaccines, perceived social norms, and the persuasive influence of peer groups. Health care provider recommendations are presented as an exemplar of factors related to the family's interface with the health care system. Personal factors addressed include parental health beliefs, attitudes, and knowledge related to vaccine preventable diseases and immunization, as well as cognitive heuristics that are employed in the decision-making process (e.g., omission bias, protected values, framing of information). Last, promising directions for research and suggestions for clinical practice are presented.

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Parents were accepting of the idea of vaccinating their adolescent children against STIs. The most salient issues were severity of infection and vaccine efficacy, not sexual transmissibility. Parents also favored vaccines for infections that had no method of behavioral prevention available.

In this study, we sought to determine whether pertussis toxin (PT), an exotoxin virulence factor produced exclusively by Bordetella pertussis, is important for colonization of the respiratory tract by this pathogen by using a mouse intranasal infection model. By comparing a wild-type Tohama I strain to a mutant strain with an in-frame deletion of the ptx genes encoding PT (⌬PT), we found that the lack of PT confers a significant peak (day 7) colonization defect (1 to 2 log 10 units) over a range of bacterial inoculum doses and that this defect was apparent within 1 to 2 days postinoculation. In mixed-strain infection experiments, the ⌬PT strain showed no competitive disadvantage versus the wild-type strain and colonized at higher levels than in the single-strain infection experiments. To test the hypothesis that soluble PT produced by the wild-type strain in mixed infections enhanced respiratory tract colonization by ⌬PT, we coadministered purified PT with the ⌬PT inoculum and found that colonization was increased to wild-type levels. This effect was not observed when PT was coadministered via a systemic route. Intranasal administration of purified PT up to 14 days prior to inoculation with ⌬PT significantly increased bacterial colonization, but PT administration 1 day after bacterial inoculation did not enhance colonization versus a phosphate-buffered saline control. Analysis of bronchoalveolar lavage fluid samples from mice infected with either wild-type or ⌬PT strains at early times after infection revealed that neutrophil influx to the lungs 48 h postinfection was significantly greater in response to ⌬PT infection, implicating neutrophil chemotaxis as a possible target of PT activity promoting B. pertussis colonization of the respiratory tract.Bordetella pertussis is a gram-negative bacterial pathogen that colonizes the human respiratory tract, leading to a severe paroxysmal coughing disease known as whooping cough. In the absence of a human challenge model of B. pertussis infection, studies of respiratory tract colonization and disease caused by B. pertussis have been limited to animal models, of which the most well established and frequently used is the mouse intranasal inoculation model. In this model, although overt symptomatic disease is not elicited, several characteristics of the human infection are reproduced, such as multiplication and clearance of the bacteria, limitation of infection to the respiratory tract, increased severity of infection in young animals, and various systemic physiological changes (8,25,29,37). Recent studies have shown that this may also be a useful model for the preclinical assessment of acellular pertussis vaccine efficacy (6, 19). However, several aspects of the pathogenic mechanisms employed by B. pertussis and the immune response to this infection remain poorly understood.Pertussis toxin (PT) is a multisubunit exotoxin that is uniquely produced by B. pertussis and is considered one of the important virulence factors of B. pertussis. The holotoxin has an AB 5 structure (33...

We investigated health literacy and its association with the use of information sources and with barriers to information seeking in clinic-based pregnant women. The Short Test of Functional Health Literacy in Adults (STOFHLA) was used to measure health literacy in 143 English-speaking low-income pregnant women. About 15% of the participants demonstrated low health literacy. Participants with low health literacy were less likely to use the Internet and more likely to have self-efficacy barriers than participants with high health literacy. Interventions to promote information-seeking skills and Internet access are indicated for women with low health literacy.