. "Appendix E: Prospects for Immunizing Against Cytomegalovirus." New Vaccine Development: Establishing Priorities: Volume I, Diseases of Importance in the United States. Washington, DC: The National Academies Press, 1985.
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New Vaccine Development Establishing Priorities, Volume I: Diseases of Importance in the United States
Predictions on vaccine development are shown in Chapter 5.
Anticipated Vaccine Utilization
The health belief model parameters (perceptions of risk of illness, severity of illness, benefits of immunization, and barriers to vaccination) used to predict vaccine utilization are described in Chapter 6, in which scores assigned to various vaccines are displayed together for comparison.
Live Attenuated Vaccine for Nonpregnant Adolescent Females
Lay Acceptance Lay perception of the risk of illness is judged to be quite low, primarily because it seems that most parents of adolescents do not consider their own children to be at risk of having a mentally retarded child. Lay perception of the severity of mental retardation and of the benefits of a vaccine that might prevent it are considered to be quite high. Because of the relatively high frequency of adverse reactions to the vaccine, lay perception of the barriers to vaccination also are judged to be relatively high.
Provider Acceptance Because most congenital and perinatal CMV infections are clinically inapparent, physician perception of the risk of illness is judged to be low. Perception of the severity of disease caused by congenital and perinatal infection is judged to be high and a vaccine with the potential to prevent severe neurological disease probably would be perceived as having relatively high benefits, moderated somewhat by the relatively low predicted efficacy of the vaccine. The high frequency of adverse reactions to the vaccine may result in relatively high perceived barriers to its administration.
Live Attenuated Vaccine for High-Risk Individuals
Lay Acceptance Lay perceptions of the risk and severity of disease and of the benefits of the vaccine are judged to be quite high, primarily because of physician cueing and because the consequences of disease caused by CMV, including graft rejection, may be quite severe. The perception of barriers to vaccination is judged to be low, as a result of the serious nature of the underlying diseases in these patients, the perceived severity of the possible consequences of CMV disease, and the experience of these patients with intensive medical treatment.
Provider Acceptance Physician perceptions of the risk and severity of disease caused by CMV in this group of patients are judged to be quite high, because of the severe disease and relatively high fatality