Vaccine Risk Communication Interventions in the United States, 1996-2006: A Review

Abstract

Background:Vaccines have been tremendously successful in preventing many childhood diseases. However, this success has created new challenges: parents are no longer familiar with vaccine-preventable diseases and as a result the object of parental fear has shifted from diseases to vaccines. In this modern era of vaccination, vaccine risk communication plays an increasingly important role in immunization programs. A 1997 Institute of Medicine Risk Communication and Vaccination workshop concluded that: "Although health risk communication has been an active research area for several decades, the science and practice of vaccine risk communication are not yet well developed". Objective: To review vaccine risk communication interventions conducted and evaluated in the last decade in the UnitedStates while identifying opportunities for improvement in this area. Search Strategy:We searched the CSA, PubMed, and PsycINFO databases. The following search terms were used: vaccine(s), vaccination, immunization, communication, parent(s), risk, risk assessment, safety, attitude(s), belief(s). References reported in all articles identified from the database searches were reviewed to locate additional studies. Study Selection: Studies related to vaccine risk communication, including communication interventions involving parents and/or patients, and published in English between 1996 and October 2006 in peer-reviewed journals were included in this review.Data Extraction: First author, year of publication, study design, number of participants, study population, study objectives, findings, and authors' recommendations were extracted independently and in duplicate. Results:Eighteen studies met inclusion criteria; four studies were evaluations of immunization reminder systems that included an educational component. The studies included a variety of outcome measures; most commonly assessed were immunization rates, vaccine or disease knowledge, intervention material recognition, recall and/or comprehension, and parental satisfaction with the intervention materials. While there was considerable variability of findings due to the variation in types of studies, all eighteen reported some favorable finding. Overall, the authors made few recommendations regarding future vaccine risk communication strategies.Conclusions: It is difficult to determine if substantial progress has been made since the Institute of Medicine workshop; the literature is lacking due to the scant number of studies, types of interventions developed, and the limited number of rigorous evaluations. The development and rigorous evaluation of vaccine risk communication strategies is critical to the success of our immunization programs.