Values and preferences
Perception of the risk of diptheria, tetatnus, pertussis, hepatitis B, Hib and poliomyelitis among target populations varies significantly depending on local disease prevalence, cultural beliefs and awareness levels. Go to footnote 1, Go to footnote 2, Go to footnote 3, Go to footnote 4, Go to footnote 5, Go to footnote 6, Go to footnote 7, Go to footnote 8
For diphtheria, studies report that factual knowledge of the disease is generally low, yet the risk is often perceived as high during outbreaks or in regions with recent cases. In many high-income countries, diphtheria is considered a rare threat, leading to decreased awareness and sometimes lower perceived urgency to vaccinate. Go to footnote 2
Perception of the risk of tetanus tends to be higher than diphtheria due to its high case-fatality and association with wounds and childbirth, especially neonatal tetanus in low-resource settings. Go to footnote 2, Go to footnote 3
Parents of young infants and healthcare workers usually recognize pertussis as a serious illness, given its potential severity in infants. For instance, in Georgia 81% of women believed pertussis, would be serious during pregnancy while 92% believed pertussis would be serious to their infants. Go to footnote 4
For hepatitis B, awareness and perceived risk vary greatly by region. In a study among pregnant women in Uganda, perceived risk was low. Go to footnote 5
Haemophilus influenzae type b (Hib) disease is often under-recognized by the public, particularly in regions where widespread vaccination has nearly eliminated severe cases like meningitis and pneumonia. Go to footnote 3
In regions where polio remains endemic, such as Afghanistan and Pakistan, the public is often more aware of the disease's dangers due to its ongoing presence. However, challenges like misinformation, cultural resistance, and distrust in vaccination programs can undermine risk perception, even in high-risk areas. Conversely, in polio-free regions, the perceived risk of polio is generally low, as the disease is no longer part of the collective memory. This complacency can lead to gaps in vaccination coverage, as seen in recent outbreaks of vaccine-derived poliovirus (cVDPV) in previously polio-free countries such as the United Kingdom and Israel. Go to footnote 1, Go to footnote 6, Go to footnote 7
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Centers for Disease Control and Prevention (CDC) (no date). Polio Vaccine Questions and Answers. Available at: https://www.cdc.gov/vaccines/vpd/polio/public/index.html (accessed 30 June 2025).
- Go back to footnote reference 2aGo back to footnote reference 2bGo back to footnote reference 2c
Babandi, Z.S., Suleiman, A.G., Darma, M.A., Indabo, U.H., Shehu, S., Hamza, A.S., Henry, J., Umar, U.M., Ojediran, S.L., Amadu, L., Ibrahim, M.S. & Ejembi, C.L. (2024). Knowledge and Perception of Diphtheria among Residents of a Rural Community in Kaduna State, Northwest Nigeria. Journal of Community Medicine and Primary Health Care, 36, pp.111–123. https://doi.org/10.4314/jcmphc.v36i2.9
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Hilton, S., Hunt, K. & Petticrew, M. (2007). Gaps in parental understandings and experiences of vaccine-preventable diseases: a qualitative study. Child Care Health Dev., 33(2), pp.170–179. doi:10.1111/j.1365-2214.2006.00647.x.
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Chamberlain, A.T., Seib, K., Ault, K.A., Orenstein, W.A., Frew, P.M., Malik, F., Cortés, M., Cota, P., Whitney, E.A.S., Flowers, L.C., Berkelman, R.L. & Omer, S.B. (2015). Factors Associated with Intention to Receive Influenza and Tetanus, Diphtheria, and Acellular Pertussis (Tdap) Vaccines during Pregnancy: A Focus on Vaccine Hesitancy and Perceptions of Disease Severity and Vaccine Safety. PLoS Currents. https://doi.org/10.1371/currents.outbreaks.d37b61bceebae5a7a06d40a301cfa819
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Nankya-Mutyoba, J., Aizire, J., Makumbi, F., Ocama, P. & Kirk, G.D. (2019). Hepatitis B virus perceptions and health seeking behaviors among pregnant women in Uganda: implications for prevention and policy. BMC Health Services Research, 19, 760. https://doi.org/10.1186/s12913-019-4516-0
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Global Polio Eradication Initiative (GPEI) (no date). Polio Today: Endemic Countries. Available at: https://polioeradication.org/where-we-work/polio-endemic-countries/ (accessed 30 June 2025).
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Circulating vaccine-derived poliovirus count. In: Global Polio Eradication Initiative [website]. Geneva: Global Polio Eradication Initiative; no date (https://polioeradication.org/circulating-vaccine-derived-poliovirus-count/, accessed 24 June 2025).
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Al Bashar, L., Dube, E., Kandasamy, T., Zaini, N., Abdul Rahman, H., et al. (2023) ‘Parents’ and healthcare professionals’ perception toward the introduction of a new fully liquid hexavalent vaccine in the Malaysian national immunization program: a cross-sectional study instrument development and its application’, Frontiers in Immunology, 14. https://doi.org/10.3389/fimmu.2023.1052450.
