Combination vaccines contain the antigens of multiple diseases and are used in place of single antigen vaccines to decrease the number of injections a child must receive. Other benefits of combination vaccines include less paperwork, less time spent in the healthcare facility, fewer office visits, higher coverage rates, reduced vaccine administration costs for the family, and increased safety for both the child receiving the injection and the nurse administering it [8]. They also decrease the risk for medical errors and errors in recordkeeping, and save money because the healthcare practice does not need to stock as many vials [17]. However, combination vaccines pose unique challenges as well, mainly in the areas of research and development. Pharmaceutical companies must ensure that each component vaccine is compatible and will not decrease the effectiveness of the others, and costly drug trials must be performed even if the component vaccines have already been proven safe and effective [10] and [21].
Before being licensed it must be shown that a new combination vaccine does not increase the risk of adverse effects above that of the component vaccines [17]. Vaccines are tested in larger numbers of children and for longer amounts of time than are other drugs [24]. However, parents are wary of pharmaceutical companies and 19% disagreed with the statement that “immunizations are always proven safe before they are approved for use” ([11], p. 1099). Perceptions of combination vaccines are significant because a systematic review conducted in 2010 found that negative views about combination vaccines tended to correlate with lower vaccine uptake [3].
Parents in one qualitative study on the “5-in-one”, DTaP/IPV/Hib vaccine expressed an appreciation for the convenience of combination vaccines. As one mother puts it, “Well it's all over and done with then isn’t it. It's all out the way, so you haven’t got to think I’ve got an injection this week and another one next week,” ([34], p. 7402). On the other hand, 8 of the 22 parents interviewed for the same study said they would rather have single antigen vaccines whenever possible. A survey was sent out to 2253 parents in East Berkshire, England to gauge their attitudes about the introduction of new vaccines. Of the 859 respondents, 612 expressed a preference to the question of whether they would rather new vaccines be given separately or in combination with other immunizations. Seventy-one percent (n = 434) of them said they would prefer the single vaccine [2]. The primary reasons they gave were fear of immune overload (44%) and belief that the combination vaccine would cause more side effects (29%). On the other hand, 98 of the 105 parents who would choose the combination vaccination for their child would do so to decrease the number of injections and make the experience less distressing for their child. The findings are limited by a relatively small sample size, but this study does provide useful insight into parents’ motivations.
Combination vaccines contain the antigens of multiple diseases and are used in place of single antigen vaccines to decrease the number of injections a child must receive. Other benefits of combination vaccines include less paperwork, less time spent in the healthcare facility, fewer office visits, higher coverage rates, reduced vaccine administration costs for the family, and increased safety for both the child receiving the injection and the nurse administering it [8]. They also decrease the risk for medical errors and errors in recordkeeping, and save money because the healthcare practice does not need to stock as many vials [17]. However, combination vaccines pose unique challenges as well, mainly in the areas of research and development. Pharmaceutical companies must ensure that each component vaccine is compatible and will not decrease the effectiveness of the others, and costly drug trials must be performed even if the component vaccines have already been proven safe and effective [10] and [21].Before being licensed it must be shown that a new combination vaccine does not increase the risk of adverse effects above that of the component vaccines [17]. Vaccines are tested in larger numbers of children and for longer amounts of time than are other drugs [24]. However, parents are wary of pharmaceutical companies and 19% disagreed with the statement that “immunizations are always proven safe before they are approved for use” ([11], p. 1099). Perceptions of combination vaccines are significant because a systematic review conducted in 2010 found that negative views about combination vaccines tended to correlate with lower vaccine uptake [3].Parents in one qualitative study on the “5-in-one”, DTaP/IPV/Hib vaccine expressed an appreciation for the convenience of combination vaccines. As one mother puts it, “Well it's all over and done with then isn’t it. It's all out the way, so you haven’t got to think I’ve got an injection this week and another one next week,” ([34], p. 7402). On the other hand, 8 of the 22 parents interviewed for the same study said they would rather have single antigen vaccines whenever possible. A survey was sent out to 2253 parents in East Berkshire, England to gauge their attitudes about the introduction of new vaccines. Of the 859 respondents, 612 expressed a preference to the question of whether they would rather new vaccines be given separately or in combination with other immunizations. Seventy-one percent (n = 434) of them said they would prefer the single vaccine [2]. The primary reasons they gave were fear of immune overload (44%) and belief that the combination vaccine would cause more side effects (29%). On the other hand, 98 of the 105 parents who would choose the combination vaccination for their child would do so to decrease the number of injections and make the experience less distressing for their child. The findings are limited by a relatively small sample size, but this study does provide useful insight into parents’ motivations.
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