IUPUI researchers evaluate communication strategies for HPV vaccination

Michele Bachmann recently reignited the controversy surrounding the human papillomavirus vaccination. During the Republican presidential debate in Tampa, Fla., she said it causes “mental retardation” and is potentially dangerous.

But a group of professors and researchers at the IU-Purdue University Indianapolis Kelley School of Business and IU School of Medicine in Indianapolis begs to differ.

Dena Cox, a professor of marketing and faculty fellow at Kelley in Indianapolis, has received a $99,600, two-year research grant from Merck pharmaceutical company to study how consumers process information about the HPV vaccine and act on the information they received.

Dena Cox, the principal investigator, will be accompanied by her husband, Anthony Cox, chancellor’s faculty fellow and professor of marketing at Kelley, and Gregory Zimet, professor of pediatrics and co-leader of the cancer control program in the School of Medicine.

The trio has worked on research projects in the past that analyzed the HPV vaccine.
“We were intrigued by it originally because it is something novel in that it was the first vaccine where its sole purpose was to prevent cancer,” Anthony Cox said.

He said he and his wife, with backgrounds in consumer marketing and research, wanted to investigate consumer questions that had a purpose.

“Why not look at consumer questions that actually matter?” Anthony Cox said. “It might have a positive impact on the consumers.”

They chose to look into vaccinations, especially the HPV vaccine, because there is a lot of misinformation that misleads the consumer, he said.

“We want to cut through the clutter so parents can make informed decisions about their daughters and so patients can make informed decisions about themselves,” he said.
Using a sampling of women aged 18 to 26 who have not yet received all three, if any, of the HPV vaccinations, they will divide the sampling into different groups and present each group with information about the vaccination in different forms.

They will look at the relationship between what medium provided them the information, their comprehension of that information and their intention to get vaccinated. Six months later, the researchers will follow up with survey participants.

“Vaccinations are the victim of their own success,” Zimet said.

In other words, once a vaccination is proven successful, the consumers quit worrying about the disease it cured or prevented and start questioning the side effects of the shot, Zimet said.

One issue he said he wants to resolve exists in the tendency of humans to automatically associate negative side effects with vaccines they recently had, which he called a “rational error.”

Preventing misinformation means asking questions and becoming educated on the issue at hand, said Darron Brown, professor of medicine, microbiology and immunology in the Division of Infectious Diseases.

“The best way is to talk to your own doctor about it,” he said. “Trying to become a scientist yourself if you aren’t one is difficult. Vaccination is the greatest public health achievement the world has ever known.”

Zimet and Brown both said the medical community continues to refute claims the vaccine is harmful to those who receive it.

“I see the controversy as manufactured,” he said. “There are some people who have strong opinions and believe the vaccine is

dangerous. But from a scientific perspective, there is no controversy. This is the first major cancer-preventing vaccination. And ... the fact that there even is any controversy is absurd to me. We should be celebrating.”

The researchers’ goal in this two-year project is to eliminate this controversy and discover ways to strengthen communication between the medical and consumer worlds, Anthony Cox said.

“We hope to find improved ways to communicate to parents the information, to encourage parents to get their daughters vaccinated and young women to vaccinate themselves as well, and that includes a lot of people in Bloomington,” Zimet said.


What is HPV?
HPV, or the human papillomavirus, is a sexually transmitted disease that usually goes undetected but can cause genital warts.
“HPV is common,” said Diana Ebling, a doctor and medical director at the IU-Bloomington Health Center. “Some studies show that 75 to 80 percent of young adults will contract it at one time or another.”

How does HPV relate to cervical cancer?
HPV strands 16 and 18 have been proven to cause 70 to 75 percent of cervical cancer.
“12,000 women in the U.S. get cervical cancer every year and 4,000 die,” said Anthony Cox, chancellor’s faculty fellow and professor of marketing at the Kelley School of Business in Indianapolis. “If you could prevent 70 percent of those deaths, it would be like preventing a 9/11 every year.”

What does the vaccine do?
There are two HPV vaccinations that have been approved by the Food and Drug Administration for women aged nine to 26: Gardasil and Cervarix.
The vaccination comes in three rounds, costing about $155 per shot. But women in that age group who have health insurance can get the vaccinations and are usually covered through their insurance plans.
“Financial issues shouldn’t stop someone,” Ebling said.
Students without insurance can apply through Merck pharmaceutical company to be vaccinated free of charge.
“I would encourage all female students to get the vaccine,” Ebling said. “The vaccine covers two types of HPV that could increase a woman’s risk for cervical cancer.
“Ideally before someone becomes sexually active, but even if someone is already sexually active we still encourage them to get the vaccine because Gardisil prevents four types of HPV, two of which increase the risk of cervical cancer, and two other strands, 6 and 11, which cause 90 percent of genital warts.”
The FDA has also approved males aged nine to 12 to receive Gardasil shots, which prevent penile cancer and genital warts caused by HPV.    


How to get vaccinated at IU
1. Check with your health insurance company to see if it covers the HPV vaccine.
2. If not, come to the IU Health Center and fill out a form for Merck’s free Gardasil vaccine.
3. Call 812-855-7688 and make an appointment at the immunization clinic. Both Gardasil and Cervarix are offered at the IU Health Center.

How it compares
The below graph estimates the number of new STD infections each year.