Research Activities, October 2010: Safety/Quality of Care: Parents continue to weigh vaccine benefits with adverse effects when deciding to vaccinate their children

Safety/Quality of Care
Parents continue to weigh vaccine benefits with adverse effects when deciding to vaccinate their children

As newer vaccines focus on preventing illness rather than death, concerns about vaccine safety have become prominent. The number of parents refusing to vaccinate their children continues to grow as perceptions about the risks of vaccination come to outweigh perceived benefits. A Group A Streptococcus (GAS) vaccine is being developed that may protect against strep throat, rheumatic fever, and serious invasive disease (e.g., septic arthritis and toxic shock syndrome) and related deaths.

A new study shows that parents prefer to prevent GAS disease in children compared with preventing minor adverse vaccine events. However, preventing vaccine-related problems remains important to them. Policymakers should consider these parental preferences when implementing new vaccination programs in the United States, suggest the study authors. They did telephone interviews with 119 parents of children diagnosed with GAS pharyngitis at 2 pediatric practice sites in a large metropolitan area. Parents were asked both willingness-to-pay (WTP) and time tradeoff (TTO) questions about short-term (2 days to 3 weeks) health states associated with GAS disease and vaccination in their child. For each of the listed health states, the WTP question was: "Using money available to you today, think about how much money you would be willing to pay to prevent your child from having this condition?" The TTO question was "Think about how many hours or days you would be willing to give up from the end of your life in order to prevent your child from having this condition?"

Median WTP and discounted TTO values were local vaccine reaction, $30, 0.12 days; systemic vaccine reaction, $50, 0.22 days; impetigo, $75, 1.25 days; strep throat, $75, 2.5 days; septic arthritis, $1,000, 6.6 days; and toxic shock syndrome, $3,000, 31.0 days. The researchers concluded that parents were willing to trade more time and money to avoid severe health states (e.g., septic arthritis, toxic shock syndrome) associated with GAS disease compared with mild GAS disease states (e.g., impetigo, strep throat) or minor vaccine adverse events. However, parents were willing to pay more per incremental health gain to avoid vaccine adverse events ($60,000 per quality-adjusted life year {QALY}) compared with avoiding health states associated with GAS disease ($18,000 to $36,000 per QALY). This study was supported by the Agency for Healthcare Research and Quality (HS13908).

See "Preferences for health outcomes associated with Group A Streptoccal disease and vaccination," by Grace M. Lee, M.D., M.P.H., Joshua A. Salomon, Ph.D., Charlene Gay, B.A., and James K. Hammitt, Ph.D., in the Health and Quality of Life Outcomes 8(28), 2010.

Research Activities, October 2010: Safety/Quality of Care: Parents continue to weigh vaccine benefits with adverse effects when deciding to vaccinate their children