Cross-School Researchers Receive NIH Grant to Identify Barriers to Accepting a New Vaccine 

A team of researchers from Penn’s Schools of Medicine, Nursing, and Communication has received a 4-million-dollar, five-year grant from the National Institutes of Health (NIH) to identify ways to increase vaccination rates. Their work will focus on the drivers of acceptance of an anticipated HIV vaccine. Joining forces are Dolores Albarracin, the project director and Alexandra Heyman Nash University Professor at the University of Pennsylvania, who directs the Annenberg Public Policy Center’s Science of Science Communication Division, and co-investigators Ian Frank, a Professor at the Perelman School of Medicine and Director of Antiretroviral Clinical Research within the Infectious Diseases Division and a member of the NIH HIV Vaccine Trials Network, Jose Bauermeister, Professor of Family and Community Health at the School of Nursing and a leading expert in sexual minority health, and Bita Fayaz-Farkhad, Sally Chan, Annie Jung, and Sicong Liu, researchers at the Annenberg School for Communication. Annenberg Senior Research Coordinator Christopher Quasti will be part of the research team as well.

“By building the evidence base on the individual and societal factors that predict vaccination uptake, this work will set the foundation for better forecasting and intervention,” commented Albarracin, who went on to explain,  “The COVID-19 pandemic increased interest in reluctance to vaccinate and led to the development of a variety of theories about its causes. Although a common one attributes the reluctance to misinformation, vaccines are created and rolled out within a complex social context that includes intertwined norms, public communications, and public health policies. Understanding the causal pathways to vaccination requires the kind of cross-disciplinary effort this grant will facilitate.” The researchers will study how health and social policies and norms affect acceptance of vaccines, in general, and a future HIV vaccine, in particular.  

Regarding the future of an HIV vaccine, Dr. Frank stated: “Despite the effectiveness and availability of antiviral medications for HIV pre-exposure prophylaxis (PrEP) to prevent infection among those currently uninfected with HIV, an inexpensive and effective HIV vaccine remains a global health priority. After years of study, we finally understand the type of vaccine-induced immune response that will be protective, and we are now testing several innovative HIV vaccine concepts that we hope will stimulate our immune systems to make this response. We need the support of the HIV-positive community to participate in the research studies needed to evaluate HIV vaccine candidates. Once we've shown that we have an effective vaccine, we need to ensure the community at-risk for HIV infection will get vaccinated.” 

This project will investigate how to ensure vaccination if the FDA approves an HIV vaccine.

The project will entail two extensive studies. After gathering a national sample of men who have sex with men (MSM), a group that has historically borne the brunt of the HIV burden, the researchers will ask them to complete surveys regarding norms, policies, and attitudes about vaccinations over four years. 

During the same period, the team will conduct a quantitative study of all state and county-level policies, including both pre-existing policies and ones created during the study, that concern all immunizations in the Center for Disease Control’s (CDC) vaccination schedule (e.g., the Measles, Mumps, and Rubella (MMR), Influenza vaccines, etc.), as well as health issues that are relevant to the Lesbian, Gay, Bisexual, Transgendered, and Queer (LGBTQ+) community. The research team will record state and county-level policy changes made throughout the study, including those in vaccine funding, accessibility, and nonmedical exemptions. Other policies that concern LGBTQ+ health will be investigated, as will the effects of these policies on healthcare seeking and vaccination.

The research team will also track social media platforms and the user posts regarding vaccines and immunization policies to gauge collective opinions and feelings about such matters as vaccine mandates and access to vaccination sites. By combining surveys, information about surveys, actual state and county-level policies, and social media analysis, the team will be able to determine societal trends about vaccines, health, and LGBTQ+ issues in different regions across the United States in a detailed way. 

In addition, the researchers will conduct an experiment to identify factors that predict public acceptance of future vaccines, in general, and, specifically, the willingness of MSM to receive potential HIV vaccines with different side effect profiles and the number of doses.

Collecting information across four years will allow researchers to separate the effect that certain policies can have on MSM from factors that may correlate with those policies.

As Dr. Albarracin put it, “Correlating policies with public opinion and behaviors without across time studies is insufficient to justify causal inferences. Through long-term observation and controlled experiments, we will determine, for example, whether the norms in the population affect the policies or whether the policies affect the norms. Through these efforts, we will determine what types of communications and policies are most effective for different regions of the country or different vaccines.”