An exploratory study of students' understandings and experiences of vaccination : implications for future HIV vaccine trials in South Africa.
As Africa faces the challenges of its renewal or renaissance, the HIV/AIDS epidemic poses the greatest potential barrier to the attainment of this vision (Makgoba, 2001 in Dorrington, Bourne, Bradshaw, Laubscher & Timaeus, 2001). The development of an HIV vaccine that is safe, effective and affordable, has been widely contemplated as a necessary supplement to already established interventions. In preparation for HIV vaccine trials in South Africa the current project aimed to assess students' understanding (knowledge and perceptions) and experiences of vaccination in general, and to explore if these were associated with demographics such as motherhood and gender. A parallel aim was to assess students' knowledge and expectations of HIV vaccination and trial participation. A sample of 33 students was recruited from university residences at the University of Natal, Pietermaritzburg. Participants were interviewed via a semi-structured interview schedule. The data collected was then coded and analysed using content analysis, while Chi - square analysis was used to evaluate if demographics such as gender and motherhood were systematically associated with various responses. The results revealed that the vast majority of participants (97%) knew the purpose of vaccination, stating that it was to promote health and prevent illness. Most participants (67%) knew that vaccination works by mobilising the immune system (vaccination mechanism). The vast majority of participants (91%) could name at least one vaccine preventable disease. Uptake of childhood immunisation was reportedly high (88%) while adult uptake of immunisation was low (33%). A significant minority (36%) reported that they had experienced side effects but understood these to be an integral part of vaccination. Thirty percent of participants stated they were willing to participate (WTP) in a hypothetical vaccine trial, 33 % of participants were not WTP and 15% were not sure. Motivations for trial participation were reportedly influenced most by personal incentives of altruism (39%) and barriers such as perceived significant physical risk (61%). In general, knowledge and experiences of vaccination were not associated with gender or with motherhood. The results suggest that more awareness of HIV vaccine trials is needed. In this regard education should emphasise that the prospective vaccine will be preventive, that only healthy people can volunteer and that the HIV vaccine will not guarantee immunity to HIV infection. Suggestions are made for future research into motivations, barriers and incentives to facilitate an ethical process of vaccine trial participation.
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Safety and efficacy of the HVTN 503/Phambili Study of a clade-B-based HIV-1 vaccine in South Africa: a double-blind, randomised, placebo-controlled test-of-concept phase 2b study. Gray, Glenda E.; Allen, Mary.; Moodie, Zoe.; Churchyard, Gavin J.; Bekker, Linda-Gail.; Nchabeleng, Maphoshane.; Mlisana, Koleka Patience.; Metch, Barbara.; De Bruyn, Guy.; Latka, Mary H.; Roux, Surita.; Mathebula, Matsontso.; Naicker, Nivashnee.; Ducar, Constance.; Carter, Donald K.; Puren, Adrian.; Eaton, Niles.; McElrath, M. Juliana.; Robertson, Michael.; Corey, Lawrence.; Kublin, James. (Elsevier., 2011)Background. The MRKAd5 HIV-1 gag/pol/nef subtype B vaccine was designed to elicit T-cell-mediated immune responses capable of providing complete or partial protection from HIV-1 infection or a decrease in viral load after ...
Gray, Glenda E.; Metch, Barbara.; Churchyard, Gavin J.; Mlisana, Koleka Patience.; Nchabeleng, Maphoshane.; Allen, Mary.; Moodie, Zoe.; Kublin, James.; Bekker, Linda-Gail. (Elsevier., 2012)Background: Increased sexual risk behaviour in participants enrolled in HIV prevention trials has been a concern. The HVTN 503/Phambili study, a phase 2B study of the Merck Ad-5 multiclade HIV vaccine in South Africa, ...
Advances in childhood immunisation in South Africa: where to now? Programme managers’ views and evidence from systematic reviews. Wiysonge, Charles Shey.; Ngcobo, Nthombenhle J.; Jeena, Prakash M.; Madhi, Shabir A.; Schoub, Barry D.; Hawkridge, Anthony.; Shey, Muki S.; Hussey, Gregory D. (BioMed Central., 2012)Background: The Expanded Programme on Immunisation (EPI) is one of the most powerful and cost-effective public health programmes to improve child survival. We assessed challenges and enablers for the programme in South ...