Risk compensation and vaccination: Can getting vaccinated cause people to engage in risky behaviors?

  • Noel T. Brewer
  • Cara L. Cuite
  • James E. Herrington
  • Neil D. Weinstein


Background: Some believe that vaccinating young women against human papillomavirus (HPV) will increase their risky behavior. In more formal terms, vaccination lowers risk perception, and people compensate for their lower perceived risk by reducing other preventive behaviors.Purpose: We test several predictions from the risk compensation hypothesis in the context of vaccination behavior.Methods: We obtained a random sample of adults (N=705), interviewing them by phone just as the Lyme disease vaccine first became available to the public and again 18 months later. Analyses controlled for age, sex, education, and race.Results: Vaccinated respondents were less likely to continue engaging in two of five protective behaviors after vaccination. The frequency of these protective behaviors did not dip below that among the unvaccinated respondents.Conclusions: We found some evidence of regression (protective behaviors dropping, after vaccination, to levels reported by the unvaccinated cohort). However, we did not finddisinhibition (exceeding the risk taking of the unvaccinated cohort), the greater threat to public health. Although we will not know for several years what effect HPV vaccination has on other behaviors, if any, data on other vaccinations can offer critically important information in the interim.


  1. (1).
    FDA:FDA Licenses New Vaccine for Prevention of Cervical Cancer and Other Diseases in Females Caused by Human Papillomavirus. Retrieved August 1, 2006 from http://www.fda.gov/bbs/topics/NEWS/2006/NEW01385.htmlGoogle Scholar
  2. (2).
    Koutsky LA, Ault KA, Wheeler CM, et al.: A controlled trial of a human papillomavirus type 16 vaccine.New England Journal of Medicine. 2002,347:1645-651.CrossRefPubMedGoogle Scholar
  3. (3).
    International Agency for Research on Cancer:IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Human Papillomaviruses. Lyon, France: IARC Science Publications, 2006.Google Scholar
  4. (4).
    Pollitt K: Virginity or death!The Nation. 2006, May 30. Retrieved February 2007 from http://www.thenation.com/doc/20050530/pollittGoogle Scholar
  5. (5).
    Wilde GJS:Target Risk. Toronto, Canada: PDE Publishing, 1984.Google Scholar
  6. (6).
    O’Neill B, Williams A: Risk homeostais: A rebuttal.Injury Prevention. 1998,4:92-3.CrossRefPubMedGoogle Scholar
  7. (7).
    Evans WN, Graham JD: Risk reduction or risk compensation: The case of mandatory safety-belt use laws.Journal of Risk and Uncertainty. 1991,4:61-3.CrossRefGoogle Scholar
  8. (8).
    Lund AK, Zador P: Mandatory belt use and driver risk-taking.Risk Analysis. 1984,4:41-3.CrossRefGoogle Scholar
  9. (9).
    National Institutes of Health: NIH Consensus Statement.Interventions to Prevent HIV Risk Behaviors. 1997,15(2):1-1.Google Scholar
  10. (10).
    Wilson TE, Gore ME, Greenblatt R, et al.: Changes in sexual behavior among HIV-infected women after initiation of HAART.American Journal of Public Health. 2004,94:1141-146.CrossRefPubMedGoogle Scholar
  11. (11).
    DiLillo D, Tremblay G: Maternal and child reports of behavioral compensation in response to safety equipment usage.Journal of Pediatric Psychology. 2001,26:175-84.CrossRefPubMedGoogle Scholar
  12. (12).
    Brewer NT, Weinstein ND, Cuite CL, Herrington J: Risk perceptions and their relation to risk behavior.Annals of Behavioral Medicine. 2004,27:125-30.CrossRefPubMedGoogle Scholar
  13. (13).
    Brewer NT, Fazekas KI: Predictors of HPV vaccine acceptability: A theory-informed systematic review.Preventive Medicine (in press).Google Scholar
  14. (14).
    Reyna VF, Farley F: Risk and rationality in adolescent decision making-Implications for theory, practice, and public policy.Psychological Science. 2006,7(1):1-4.Google Scholar
  15. (15).
    Turbin MS, Jessor R, Costa FM, et al.: Protective and risk factors in health-enhancing behavior among adolescents in China and the United States: Does social context matter?Health Psychology. 2006,25:445-54.CrossRefPubMedGoogle Scholar
  16. (16).
    Steere AC, Sikand VK, Meurice F, et al.: Vaccination against Lyme disease with recombinant Borrelia burgdorferi outer-surface lipoprotein A with adjuvant.New England Journal of Medicine. 1998,339:209-15.CrossRefPubMedGoogle Scholar
  17. (17).
    Harper DM, Franco EL, Wheeler C, et al.: Efficacy of a bivalent L1 virus-like particle vaccine in prevention of infection with human papillomavirus types 16 and 18 in young women: A randomised controlled trial.Lancet. 2004,364:1757-765.CrossRefPubMedGoogle Scholar
  18. (18).
    Brewer NT, Chapman GB, Gibbons FX, et al.: A meta-analysis of the relationship between risk perception and health behavior: The example of vaccination.Health Psychology. 2007,26:136-45.CrossRefPubMedGoogle Scholar

Copyright information

© The Society of Behavioral Medicine 2007

Authors and Affiliations

  • Noel T. Brewer
    • 1
  • Cara L. Cuite
    • 2
  • James E. Herrington
    • 3
  • Neil D. Weinstein
    • 2
  1. 1.Department of Health Behavior and Health EducationUNC School of Public HealthChapel Hill
  2. 2.Rutgers UniversityUSA
  3. 3.National Institutes of HealthUSA

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