From individual perception of vaccination risks and benefits to compliance, costs and effects of vaccination programmes: a pilot study for influenza, HPV and measles
50-53000-98-156. ZonMw, The Hague, (September 2015)Abstract
One of the most important unknowns in cost-effectiveness analysis for infectious diseases control is which proportion of the individuals in the target group chooses not to comply with the vaccination, and whether these individuals are clustered together. There is an urgent need to understand how this individual choice to vaccinate is made and how the total of individual choices will affect the public health outcome of the entire population. We propose to translate available empirical data on individual's decisions into the corresponding collective effects. To this end we will construct a synthetic aging population of 17 million individuals that is congruent with the demographics and distribution of risk-factors of the Dutch population. In this population we track individuals to reflect their decisions and we measure the public health impact of targeted vaccination programs. The approach allows public health professionals to explore and anticipate the health effects, costs and other public health consequences of individual decision making. This will allow for timely anticipation of undesired population outcomes of vaccination programs and the communication around vaccination programs, and offers an opportunity to explore which policy options will result in the most health benefits.
We propose to conduct a pilot project in which we assess anticipated uptake of various new vaccination strategies for influenza, HPV and measles, together with their health benefits. We choose to focus on these diseases as they cover a range of target populations (elderly, adolescents and infants, respectively) and as we have access to empirical data on behavior, individual choice experiments, as well as to transmission models for these infections. The proposed construction of a synthetic population that is representative of the Dutch population in demographical development, risk factors and risk perception is, to the best of our knowledge, not implemented in any project in any academic or health institution in the Netherlands. The synthetic population will incorporate the stated preference of individuals with respect to vaccination, as measured in Discrete Choice Experiments. We will construct the population such that information can be extracted at any level (e.g. national, municipal health regions), and such that there is open access to the resulting database for professionals. The proposed synthetic population offers a platform to integrate expertise and available empirical findings in the focus areas of behavior, target groups, changing demography and cost-effectiveness. As these are the focus areas for this ZonMw programme, we believe this pilot project will be a valuable addition to the knowledge infrastructure in infectious disease control in the Netherlands.