A systems approach to vaccine decision making

Lee, Bruce Y.; Mueller, Leslie E.; Tilchin, Carla

doi:10.1016/j.vaccine.2016.11.033

Cited by 34 publications

(22 citation statements)

References 47 publications

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“…As a result, they are more inclined to make a decision according to the "forgotten benefits and overstated risk" principle, which may increase their doubts about performing immunisation [6] -especially if they derive such information from unreliable non-medical sources. The conducted research confirmed that a doctor and health service have ceased to be the only source of information about vaccinations, which is confirmed in the literature [7]. Talks with one's family or friends, as well as the Internet and visited Internet forums have also gained importance.…”

Section: Discussionsupporting

confidence: 70%

Immunization of children from parents’ perspective

Majewski¹,

Madziarski²,

Pająk³

et al. 2019

polp

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Aim of the study: The aim of the study was to determine parents' sources of knowledge of vaccinations and their attitude to recommended vaccines, and to assess the effectiveness of educational intervention in terms of encouraging parents to vaccinate their children. Material and methods: Two methods were used. The first was an original survey collected in health clinics from parents seeing their paediatrician (303 surveys). The second survey had two parts, and they were collected before and after a lecture on recommended vaccines (35 surveys). The answers in both parts were then compared. Several questions with answers on a Visual Analogue Scale were used. Results: The source of knowledge of vaccination was a doctor/health service (262/303, 86%), family or friends (94/303, 31%), the Internet (86/303, 28%), media (49/303, 16%), and others (11/303, 4%). In the majority of cases (152/303, 50%) the media message was interpreted as encouraging to vaccinate. A doctor/health service remains an ultimately decisive (257/303, 85%) source of information on vaccinations. 55/303 (18%) interviewees had personal experience of side effects of vaccination, and 10 of them erroneously pointed at autism as a side effect in their opinion. Acceptance and willingness for recommended vaccines was increased after the lecture. Conclusions: Doctors and health service remain the most important and decisive source of knowledge of vaccinations. Being in favour of immunisation depends neither on education nor on place of residence. Parents' direct or indirect experience of vaccine injury is often misinterpreted (e.g. autism) but plays an important role in making decisions about recommended immunisation. The lecture proved its efficiency in educating parents about recommended vaccines and their benefits.

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Section: Discussionsupporting

confidence: 70%

Immunization of children from parents’ perspective

Majewski¹,

Madziarski²,

Pająk³

et al. 2019

polp

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“…However, as these vaccine development efforts progress, it is not yet clear what vaccine efficacies are necessary to achieve this goal with a vaccine alone, thereby eliminating the need for measures such as social distancing. As described previously, 1,2 it is important to determine the efficacy thresholds to aim for early on and during a vaccine's development. This can help identify the best candidates for various roles (e.g., vaccines that can prevent or extinguish an epidemic versus reduce the impact of an epidemic) to help guide resource allocation and also properly manage expectations once each vaccine reaches the market.…”

mentioning

confidence: 99%

Vaccine Efficacy Needed for a COVID-19 Coronavirus Vaccine to Prevent or Stop an Epidemic as the Sole Intervention

Bartsch

O’Shea

Ferguson

et al. 2020

American Journal of Preventive Medicine

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313

283

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Introduction: Given the continuing COVID-19 pandemic and much of the U.S. implementing social distancing owing to the lack of alternatives, there has been a push to develop a vaccine to eliminate the need for social distancing. Methods: In 2020, the team developed a computational model of the U.S. simulating the spread of COVID-19 coronavirus and vaccination. Results: Simulation experiments revealed that to prevent an epidemic (reduce the peak by >99%), the vaccine efficacy has to be at least 60% when vaccination coverage is 100% (reproduction num-ber=2.5−3.5). This vaccine efficacy threshold rises to 70% when coverage drops to 75% and up to 80% when coverage drops to 60% when reproduction number is 2.5, rising to 80% when coverage drops to 75% when the reproduction number is 3.5. To extinguish an ongoing epidemic, the vaccine efficacy has to be at least 60% when coverage is 100% and at least 80% when coverage drops to 75% to reduce the peak by 85%−86%, 61%−62%, and 32% when vaccination occurs after 5%, 15%, and 30% of the population, respectively, have already been exposed to COVID-19 coronavirus. A vaccine with an efficacy between 60% and 80% could still obviate the need for other measures under certain circumstances such as much higher, and in some cases, potentially unachievable, vaccination coverages. Conclusions: This study found that the vaccine has to have an efficacy of at least 70% to prevent an epidemic and of at least 80% to largely extinguish an epidemic without any other measures (e.g., social distancing).

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“…A fourth prong is to use systems methods to better diagnose coping situations and determine their impact. As we have previously indicated,8 11 12 39 without assistance, humans can struggle to understand the reverberating effects of a change throughout a complex system. Systems mapping and modelling can help elucidate and quantify such effects and identify ways to address resulting problems.…”

Section: Discussionmentioning

confidence: 99%

“…Since immunisation is crucial to protecting populations against potential life-threatening or life-altering diseases, the consequences of coping masking inadequate immunisation systems can be substantial. They can also be complex and difficult to follow unaided as immunisation supply chains are complex 11 12. Therefore, to assess the broader impact of varying degrees of coping behaviours, we developed a computational simulation model of the routine immunisation supply chain of Bihar (a state in India), where coping (in this case, making additional shipments of vaccines above stated policy) is known to occur.…”

Section: Introductionmentioning

confidence: 99%

How coping can hide larger systems problems: the routine immunisation supply chain in Bihar, India

et al. 2019

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IntroductionCoping occurs when health system personnel must make additional, often undocumented efforts to compensate for existing system and management deficiencies. While such efforts may be done with good intentions, few studies evaluate the broader impact of coping.MethodsWe developed a computational simulation model of Bihar, India’s routine immunisation supply chain where coping (ie, making additional vaccine shipments above stated policy) occurs. We simulated the impact of coping by allowing extra trips to occur as needed up to one time per day and then limiting coping to two times per week and three times per month before completely eliminating coping.ResultsCoping as needed resulted in 3754 extra vaccine shipments over stated policy resulting in 56% total vaccine availability and INR 2.52 logistics cost per dose administered. Limiting vaccine shipments to two times per week reduced shipments by 1224 trips, resulting in a 7% vaccine availability decrease to 49% and an 8% logistics cost per dose administered increase to INR 2.73. Limiting shipments to three times per month reduced vaccine shipments by 2635 trips, which decreased vaccine availability by 19% to 37% and increased logistics costs per dose administered by 34% to INR 3.38. Completely eliminating coping further reduced shipments by 1119 trips, decreasing total vaccine availability an additional 24% to 13% and increasing logistics cost per dose administered by 169% to INR 9.08.ConclusionOur results show how coping can hide major system design deficiencies and how restricting coping can improve problem diagnosis and potentially lead to enhanced system design.

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A systems approach to vaccine decision making

Cited by 34 publications

References 47 publications

Immunization of children from parents’ perspective

Immunization of children from parents’ perspective

Vaccine Efficacy Needed for a COVID-19 Coronavirus Vaccine to Prevent or Stop an Epidemic as the Sole Intervention

How coping can hide larger systems problems: the routine immunisation supply chain in Bihar, India

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