A Spatial and Temporal Sentiment Analysis of the Human Papillomavirus Vaccine in the European Union and the United States

Abstract

The human papillomavirus (HPV) is a sexually transmitted, oncogenic pathogen. High-risk forms of HPV are known to be the foremost cause of cervical cancer worldwide, thus placing a major burden of disease globally in the female population. With the emergence of three separate vaccines (Gardasil, Gardasil-9, and Cervarix) and the introduction of vaccination programs throughout the globe starting in mid-2006, there has been a recent revolution in the treatment and preventative care of HPV. In fact, vaccination has been shown to be the most effective form of protection against HPV infection. However, the relatively novel introduction of the vaccine and the sexual means of transmission have led to a whole new set of problems in terms of vaccine refusal. Specifically, vaccine refusal was observed to have grown stronger in the European Union starting in mid-2013 due to increased concerns that the vaccine was causing side effects, such as Postural Orthostatic Tachycardia Syndrome (POTS) and Complex Regional Pain Syndrome (CRPS). In response to this, at the request of Denmark, the European Medicines Agency (EMA) launched an investigation into the safety profile of the vaccine. Simultaneously, in conjunction with the London School of Hygiene and Tropical Medicine (LSHTM), the EMA conducted a media monitoring project to analyze public HPV vaccine sentiments. On November 5th, 2015, they released a report stating that there was not, in fact, a causal link between the vaccine and POTS or CRPS.This thesis aims to explore the factors that have inhibited vaccine confidence in both the European Union (EU) and the United States through analyzation of the database produced through the HPV Media Monitoring Project. Through this analysis, I will be able to examine vaccine concerns that have arisen in the EU and the United States in the vaccine’s post-authorization phase. My research objective here is three-fold: 1) to determine how European sentiments shifted following release of the EMA review, 2) to examine whether there was any spillover affects from the EMA review in the United States, and 3) to qualitatively examine, compare, and contrast the major concerns that have motivated vaccine refusal in Europe and the United States.