The number of vaccines recommended by the World Health Organization for every country to include in government-sponsored childhood vaccination programs has rapidly increased over the past fifteen years, although there is little research regarding the best approach to new vaccine introduction into a population that may be unfamiliar with the specific disease prevented. However, the circumstances surrounding the initial rollout of a vaccine may exert a lasting impact on perceptions of the vaccine and the disease prevented (e.g., human papillomavirus (HPV) vaccine uptake is extremely low more than ten years after its introduction in the US). This mentored training program will build upon my strong educational base in epidemiology, and will help me develop skills in decision and implementation sciences to reach my long-term goals: to understand how attitudes towards vaccines change over time as more vaccines become available; and to develop interventions that can effectively minimize distrust when a vaccine is newly introduced into a population. The training program in this grant will familiarize me with relevant methodological approaches; I will gain expertise in (1) developing health messages, (2) researching people?s preferences for health care interventions, (3) understanding governmental perspectives on vaccine adoption, and (4) managing complex international studies. The research goal of this proposal utilizes this training regimen to characterize how the inherent characteristics of a vaccine-preventable disease (as presented during vaccine introduction) affect the valuation of a specific vaccine and the entire vaccination program. Data sources include a longitudinal study of parents from Shanghai and national surveys from China and the US. Specifically, I will (1) measure changes in the risk perception of several vaccine-preventable diseases before and after the vaccine is publicly funded, (2) characterize preferences for vaccine profile and vaccination program attributes during vaccine introduction, and (3) examine how the framing of HPV vaccination across several dimensions affects willingness to receive it. This proposal will generate pilot data to support a future R01 grant, which will test the effectiveness of systemic- and provider-level activities and interventions on the uptake of HPV vaccine while also aiming to reduce vaccine hesitancy. Ideally, the adoption of new vaccines in China accompanying the expansion of their government sponsored childhood vaccination program can avoid the pitfalls experienced in other countries with new vaccine introduction, and in turn inform vaccine introduction strategies in the US. This grant proposal is supported by an advisory team comprising Dr. Matthew Boulton?a physician-epidemiologist with expertise in childhood immunization and the control of vaccine-preventable diseases; Professor Lisa Prosser?an interdisciplinary health policy researcher with a research focus on vaccine decision-making; Professor Brian Zikmund-Fisher?a leader in health messaging and risk communication; and Dr. Xiaodong Sun?the Director of Immunization Programs at the Shanghai Centers for Disease Control and Prevention.
/PUBLIC HEALTH IMPORTANCE Flawed vaccine rollout can impact long-term vaccination rates (such as for HPV vaccine in the US), but little is known about how to optimize vaccine introduction. This study examines how the inherent characteristics of a vaccine-preventable disease (as presented during vaccine introduction) affect valuation of a vaccine and how perceptions of a disease change over time after vaccine rollout. This information can be used to optimize vaccine adoption strategies, and to bolster future vaccination coverage and long-term willingness to receive a vaccine.