Skip to main content

Table 4 Educational messages

From: Development of an efficient strategy to improve HPV immunization coverage in Japan

Content of the messages

Message 1: Loss of future fertility by not vaccinating

 -Invasive cervical cancer in younger women has doubled, compared to 20 years ago

 -Hysterectomy is usually needed for invasive cervical cancer, even if it is found at an early stage, and afterwards the patient can’t conceive

Message 2: Loss of the future benefits by postponement of vaccination

 -Efficacy of HPV vaccine is reduced if girl not inoculated before first sexual intercourse

Message 3: Expectations for the vaccine (dispelling the negative image of adverse events)

 -The Nobel Prize was awarded for discovery of HPV

 -The vaccine has been developed through study for as long as 20 years after discovery of HPV

 -The vaccine has been approved in about 120 countries/regions worldwide

Message 4: Comparison of future benefits by vaccination with near-term losses

 -The vaccine is effective in preventing cervical cancer, with a probability of 60–70 % in the future

 -Severe adverse events occur after vaccination in only about 0.007 % of girls

Message 5: Safety of vaccination (changing the focus away from serious adverse events)

 -HPV vaccine is given safely in about 99.993 % of girls

  1. Message 1 was created using the theory of ‘loss avoidance’, which is one of the most representative theories in behavioral economics. By emphasizing the increase of cervical cancer incidence in younger women compared to 20 years ago, and the possibility of needing to undergo a hysterectomy for cervical cancer, Message 1 explains the magnitude of loss caused by avoiding vaccination. Conservative mothers usually attempt to minimize change. Message 2 aimed to make conservative mothers recognize future loss caused by postponement of vaccination; it told them that selecting the conservative status quo meant selecting the possibility of their daughter suffering cervical cancer [2]. Message 3 conveyed information to increase confidence in the reliability and safety of the vaccine, because many of the mothers obviously felt uneasy about it. This message encouraged the mothers to perceive of the vaccination more positively by dispelling the near-term-loss image of adverse events. Message 4 used a numeric comparison of the merits and risks of vaccination. It showed how unwillingness to vaccinate their daughters meant selection of future bad consequences for them. For creating Message 5, we utilized the framing theory of behavioral economics, by creating a way to show numerical data that significantly affects decision-making. In this message, the safety of the HPV vaccine was expressed by the impressive-looking number of 99.993 %, thus changing the focus from the rare probability of severe adverse events, 0.007 % [14]
Back to article page

BMC Public Health

ISSN: 1471-2458

Contact us