The results of this real-world survey of people living in four TBE-endemic regions in Europe demonstrate high levels of self-reported knowledge about common vaccines and high awareness of TBE across the study group. was highly consistent with previous European studies ( 24 ). Previous reports on general vaccine uptake indicate that the majority of participants trust and rely on physicians/healthcare professionals for vaccine recommendations and in supporting patients in vaccine decision-making. It has been highlighted that physicians/healthcare workers play a vital role (28).
Self-protection was the top motivator for getting vaccinated, but severity of the disease, protection of children and family members, and advice and recommendations from doctors/healthcare professionals were also rated highly by more than half of participants. As expected, most participants rated vaccine efficacy and frequency of side effects as the most important single TBE vaccine attributes to consider, but more than half rated vaccine efficacy and frequency of side effects as the most important single TBE vaccine attributes to consider, but more than half also evaluated booster immunization intervals and the frequency of side effects against other TBE strains that differed geographically. Cross-protection was also rated as important or very important.
The importance of boost time interval and cross-protection was further validated by the results of discrete choice analysis, and these attributes were ranked as most influential in selecting a preferred hypothetical TBE vaccine . When participants were asked to select their preferred hypothetical TBE vaccine profile, a 10-year boost interval was the most preferred attribute level compared to a 3- or 5-year interval. On the other hand, profiles providing cross-protection against other TBE strains were highly favored compared to profiles without cross-protection.
The desire for mutual protection may not be surprising given that all three variants of TBEV are currently prevalent in the Baltic states, and the European and Siberian variants are prevalent in Finland. No (2, 13, 14). However, the reason why longer booster intervals are preferred is less clear. We speculate that the convenience of the extended booster schedule, mixed with the recognition that longer booster intervals enhance vaccine efficacy, may have influenced decision-making in this study. . However, it should be noted that discrete choice findings indicate preferences within the context of other available choices. Therefore, if an attribute level is extended to a longer or shorter booster interval, it is likely that the new level will outperform the 10-year booster in terms of priority.
Nevertheless, in the context of this study, it is clear that there was a preference for longer booster vaccination intervals compared to 3- or 5-year intervals (18, 19), and perhaps this is why This probably explains why we adhere to the current booster vaccination recommendation of one dose. 5 years is consistently low across Europe (24). We believe that recommending longer booster intervals may improve vaccine compliance and lead to a reduction in the incidence of TBE cases in Europe. Indeed, the Swiss recommendation agency has already updated the recommendation for TBE vaccine boosting from once every 3 years to once every 10 years (29). Promisingly, the results of a retrospective analysis conducted in Switzerland between 2006 and 2020 show that TBE vaccines are less effective among fully vaccinated people, even if the last dose was more than 10 years ago. (30). Furthermore, TBE surveillance data collected during this period showed no evidence of a dramatic increase in TBE associated with a longer boost interval in any age group, and a marked improvement in the acceptability of the TBE vaccine among the Swiss population. (31). Our observations of a clear preference for this type of extended boost interval, together with existing and prospective efficacy data, should guide updates to current prescribing information for existing TBE vaccines to align with national policies. It could potentially be used to inform Europe-wide updates on TBE vaccine recommendations. Specific risks may help improve vaccine uptake.
One surprising observation in the current study was that dosing schedule was not very important in TBE vaccine decision-making among participants, with no clear preference for any of the dosing schedules presented. That was it. This is not to suggest that dosing schedule is not important to vaccinees, but rather that none of the levels presented in this study may have been particularly desirable to participants. For individuals identified as high-risk or in need of immediate protection, Encepur has an approved rapid dosing schedule in which all three doses are administered over a 21-day period for 12 to 18 months. A first booster can be given later (18). The lack of preference for this rapid dosing schedule in the current study likely indicates a lack of awareness of TBE risk among study participants, and may reflect the urgency for immediate and complete prevention. This can be translated into absence, but this requires further investigation.
Furthermore, although manufacturer country of origin was among the top three most important attributes influencing decision making in discrete choice analyses, its weighted importance was still significantly lower than booster spacing and cross protection. , suggesting its low importance. It is more important than the aforementioned attributes in hypothetical TBE vaccine decision-making. As an independent attribute, only one-third of participants considered vaccines to be very important, and while it may be a consideration for some, the majority This suggests that people may not necessarily feel a strong emotional preference for a vaccine based solely on where it is located. Manufactured.
We observed some interesting differences between demographic subgroups in terms of knowledge, reliance on physicians/healthcare workers, vaccine motivation, and preferences for specific TBE vaccine attributes. . For example, we noted that older participants valued self-protection more and were also self-proclaimed more vaccine literate. Nevertheless, compared to younger participants, a higher proportion of older participants relied on doctors/healthcare professionals for vaccine advice and recommendations. Additionally, older participants placed more emphasis on disease severity as a motivator for getting vaccinated, suggesting that health awareness and concern increases with age, which is not unexpected. there is no. Despite this, fewer participants aged 50 years and older were vaccinated, suggesting a need to improve vaccination coverage, especially in this age group. We note a similar pattern of findings primarily based on employment status, with important differences existing between retired participants and students, suggesting that age is likely a determining factor. did. With that in mind, and for the sake of brevity, we did not report data by employment type outside of the discrete choice experiment.
Interestingly, when comparing between men and women, self-protection was a more important motivation for vaccination for men than for women. Of note, the proportion of participants aged 65 and older was greater for men than for women, indicating that this observation is not due to gender and may be at least partially age-related. Suggests. Additionally, we did not observe a greater emphasis on protecting the family among women to counter this observation, as might have been expected.
Although we do not report data by endemic region with the exception of individual choice data, we do not know how much vaccine motivation among Swedish participants compared to participants from other endemic regions. I noticed that there is a difference. This may be investigated in a future publication. For example, severity of illness was a more motivating factor in Sweden, whereas advice from a doctor/health worker and a sense of obligation were more motivating factors for vaccination in this group compared to participants from other regions. (data not shown). This may be due to the higher proportion of Swedish participants who declared themselves knowledgeable/very knowledgeable about TBE, suggesting that these participants have a degree of independence. , but further research is needed to verify this observation.
Single vaccine attributes were more important among older and younger participants: efficacy, frequency and severity of side effects, physician/healthcare provider recommendation, mutual protection, and where to obtain the vaccine. However, for women, the frequency of side effects was rated as more important. male. No significant differences were observed between subgroups in the importance of booster interval. Furthermore, in the context of selecting a preferred hypothetical TBE vaccine profile, there were no substantial differences in the importance of each attribute across demographic subgroups, nor were there differences in preferences for specific attribute levels. . These findings are consistent with the overall observation that a 10-year boost interval is more favorable compared to a 3- or 5-year booster interval, and that the desirability of cross-protection against other TBE strains is greater in a broader demographic. This suggests that it may be expanded to. Age, gender, and nationality do not matter.
New insights into how TBE awareness, physician/health worker dependence, and vaccine motivations may vary on an individual basis, and perhaps from country to country, such as the ones we have shared here , which could provide information to doctors/health care workers on how to provide more vaccines. A personalized approach when recommending or prescribing TBE vaccines. It also lays the groundwork for more targeted public health education campaigns targeting at-risk groups and specific populations, such as young vaccinators who may lack general knowledge about vaccines and TBE. It is also possible to form. Our findings also provide guidance to physicians/health care workers and patients regarding the effectiveness, safety, and cross-reactivity of current TBE vaccines, given the overall importance of efficacy, safety, and cross-reactivity of these vaccines. , highlighting a unique opportunity to educate on cross-reactivity. This approach may help reduce existing fears and anxieties about TBE vaccination, as well as dispel misconceptions about existing vaccines, with the hope of improving TBE vaccine uptake.
There are some potential limitations when conducting such surveys, as market research panels can be inherently biased. By introducing population quotas, we sought to ensure that the survey population was as representative as possible of the general adult population in each surveyed region. By setting a relatively low maximum allocation of TBE vaccination coverage for each region, we are able to specifically recruit large numbers of unvaccinated individuals, and the new insights could help improve vaccination in TBE endemic countries. It may help elucidate barriers to TBE vaccination among unvaccinated individuals. However, this study was conducted across four independent countries, so caution should be taken before generalizing the results across Europe. Of note, we observed fewer differences in responses between subgroups by country than when comparing age or gender (data not shown), and this is mostly due to nationality. suggests that age or gender did not influence opinions within this study to the same extent. Nevertheless, future large-scale studies across more TBE-endemic regions, with a focus on comparisons between countries, will provide further insights. In addition to a variety of social and situational factors, there are also other factors not covered in this study that may influence preferences and attitudes toward vaccination, such as an individual’s health status, ethnicity, and religious beliefs. It is also very likely that there are other factors. Future research could explore some of these to further our understanding.
Comprehension can also be an issue in this type of research, so a number of A preliminary test was conducted.
