VACCINE acceptance for sexually transmitted infections (STIs) may depend heavily on the way recommendations are worded, according to new cross-sectional data from the USA, China, and Indonesia. Researchers found that universal recommendations consistently produced higher acceptance rates than targeted guidance, suggesting that language choice could influence the success of future STI vaccination programs.
The study examined theoretical acceptance of vaccines for chlamydia, gonorrhoea, syphilis, and genital herpes among 1,941 adults aged 18 to 45. Participants were stratified by sexual behavior and asked about willingness to receive an STI vaccine under either universal or targeted recommendation wording. Investigators then compared differences using chi-square testing and prevalence ratios from Poisson regression models.
Across all three countries, acceptance of STI vaccines tended to be lower when recommendations were presented as targeted to high-risk groups. In contrast, universal recommendations generated broader acceptance among general populations as well as those engaging in higher-risk sexual behaviors.
In the USA, the effect of wording interacted significantly with prior awareness of STIs. Participants who had heard of STIs showed increased acceptance of a vaccine, though the degree of acceptance differed depending on the framing. When universal language was used, the prevalence ratio of acceptance was 1.30 (95% CI: 1.05–1.62). Under targeted recommendations, the effect was more pronounced with a prevalence ratio of 2.45 (95% CI: 1.69–3.56).
The findings suggest that both familiarity with STIs and the type of recommendation wording shape vaccine acceptance. With vaccine hesitancy and refusal rising worldwide, the authors stress that careful attention to recommendation language and public education will be crucial as STI vaccines progress toward rollout. Strategies that combine universal messaging with informative education could improve uptake and help reach populations most in need of protection.
Reference: Santana-Garce MA et al. Role of universal and targeted recommendations for vaccines for sexually transmitted infections in the USA, China and Indonesia: a cross-sectional study. BMJ Public Health. 2025;3(2):e001897.
