United States Travelers' Concern about Zika Infection and Willingness to Receive a Hypothetical Zika Vaccine.

Nadja A Vielot,Lauren Mccormack,Sylvia Becker-Dreps,Linda Squiers,Bridget Kelly,Lola Stamm,James Herrington

doi:10.4269/ajtmh.17-0907

Abstract

.The ongoing Zika pandemic has affected many countries that are common travel destinations. We assessed the willingness to receive a prophylactic Zika virus (ZIKV) vaccine, currently under development, among travelers to areas with reported autochthonous ZIKV transmission. We surveyed United States (U.S.) residents aged 18–44 years who had ever heard of ZIKV and planned to travel to Florida and/or Texas (N = 420) or a U.S. territory or foreign country (N = 415) in 2017, using a nationally representative internet panel. Travelers to Florida and/or Texas reported less concern about ZIKV infection than travelers to other destinations (27% versus 36%, P = 0.01). Female sex, Hispanic ethnicity, discussing ZIKV with medical professionals, ZIKV risk perception, and self-efficacy for ZIKV prevention predicted concern about ZIKV infection in both groups. Travelers to Florida and/or Texas (43%) and other destinations (44%) were equally willing to receive a ZIKV vaccine. Hispanic ethnicity, discussing ZIKV with medical professionals, and concern about ZIKV infection predicted vaccine willingness in both groups. Likelihood of using existing ZIKV prevention methods, confidence in the U.S. government to prevent ZIKV spread, self-efficacy for ZIKV prevention, and knowledge about ZIKV symptoms further predicted vaccine willingness in travelers to other destinations. In multivariable analyses, only concern about ZIKV infection was associated with vaccine willingness in both groups (prevalence ratio [95% confidence interval]: Florida and/or Texas: 1.34 [1.06, 1.69]; other: 1.82 [1.44, 2.29]). Targeted communications can educate travelers, particularly travelers who are pregnant or may become pregnant, about ZIKV risk to generate ZIKV vaccine demand.

Highlights

Since its detection in Brazil in early 2015, Zika virus (ZIKV) has spread rapidly throughout Latin America and the Caribbean
ZIKV virus appears to be unique among flaviviruses in its ability to be transmitted from mother to fetus and to cause a constellation of severe birth defects known as congenital Zika syndrome.[4,5,6]
Of 5,168 symptomatic cases of ZIKV reported in United States in 2016, 4,897 cases were travelers returning from ZIKV-affected areas, 224 cases were individuals presumably infected locally by mosquito bites, and 45 cases were individuals infected by sexual transmission.[8]

Summary

Introduction

Since its detection in Brazil in early 2015, Zika virus (ZIKV) has spread rapidly throughout Latin America and the Caribbean. Most countries in the region and two United States (U.S.) states and three territories have reported local (i.e., autochthonous) mosquito-borne transmission.[1] Millions of Americans travel to these and other areas with autochthonous ZIKV transmission each year.[2] ZIKV infection is asymptomatic in up to 80% of infected persons, several characteristics make ZIKV an important concern for U.S travelers.[3] ZIKV virus appears to be unique among flaviviruses in its ability to be transmitted from mother to fetus and to cause a constellation of severe birth defects known as congenital Zika syndrome.[4,5,6] ZIKV infection has been found to be associated with the Guillain–Barresyndrome, a nervous system disorder that can cause symmetric muscle weakness and paralysis of the respiratory muscles.[7] unlike other arboviruses, there is clear evidence that ZIKV can be transmitted sexually. Of 5,168 symptomatic cases of ZIKV reported in United States in 2016, 4,897 cases were travelers returning from ZIKV-affected areas, 224 cases were individuals presumably infected locally by mosquito bites (in Florida and Texas), and 45 cases were individuals infected by sexual transmission.[8]

Methods

Results

Conclusion