Risk Perception and the Psychobiological Sequelae of Vaccination
Principal Investigator: Karen Quigley, PhD
Background: Current concerns about threats of terrorist events have led to smallpox vaccination of medical personnel, just as biological warfare concerns led to vaccination of military personnel. However, we have not considered whether knowing that a vaccine is being given for a biological agent that could be released by a terrorist would make a person see the vaccine as more or less risky than they might otherwise see it. We also do not know whether this bioterrorism vaccine situation could cause adverse consequences such as excessive psychological distress or reduce the effectiveness of the vaccine. If a vaccine taken as part of a countermeasure to bioterrorism causes people think that a vaccine is more risky than it actually is, then people may not be willing to take a very important vaccination. Also, since we know that chronic distress causes one to have a poorer response to a vaccine, then a vaccine given under bioterrorism circumstances may be less effective than we would like. Another group that may be at risk for a poor response to a vaccination are the elderly who have been shown to have poorer immune responses to vaccines.
Objectives: We will address whether a vaccine administered in a bioterrorism context leads to changes in an individual's perception of vaccine risk, and alters responses to vaccination. Our objectives are to determine: (a) whether a bioterrorism vaccine context along with having optimal information in the form of a well designed vaccine risk information sheet influences risk ratings of a vaccine, (b) whether a bioterrorism vaccine context will make physical symptoms or distress increase after a vaccination, or reduce vaccine effectiveness compared to giving a vaccine without any bioterror context, and (c) whether a bioterrorism vaccine context combined with physiological arousal at the time of vaccination will increase symptoms and psychological distress after the vaccination, and reduce vaccine effectiveness.
Research Plan: Veteran and civilian individuals will be recruited for one of several studies assessing (a) risk perceptions of a vaccine, (b) symptoms and psychological distress following a vaccine, and (c) the effectiveness of a vaccine. Other studies will be used to design the vaccine information sheets and to test a computerized risk/benefit task.
Methods: In Study 1, individuals will be randomly assigned to read either an optimized or usual vaccine information sheet just before an expected administration of a vaccine described in either a bioterror context or not. We will assess how the type of vaccine (bioterror or not) and the informational content of the information sheet influences vaccine risk perceptions. In Study 2, individuals will be randomly assigned to groups differing by type of vaccine (bioterrorism or not), and assigned to one of 2 stressor tasks in the lab (time-pressured or non-pressured). We will compare groups on vaccine-specific and non-specific symptoms, and psychological distress over the week following vaccination, their physiological stress responses during the lab task, and the effectiveness of the vaccine at 1 month after vaccination.
Results:Study 1 will allow us to examine how a vaccine given in a bioterrorism context influences risk perception of that vaccine. In addition, the study allows us to assess how optimized and non-optimized (in this case usual) vaccine information sheets affect the perception of a vaccine's riskiness. Study 2 will extend these findings by examining how the bioterrorism vaccine context influences symptoms that occur after vaccination and physiological arousal at the time of vaccine administration and how that in turn affects psychological distress in the week following the vaccine, and the body's response to the vaccine. We have finalized vaccine information sheets based on information obtained from a series of focus groups. Individuals in the focus groups helped us to adapt a previously designed vaccine information sheet for use in the future if a bioterrorism situation were to require vaccination of the public.
Status: Project is ongoing.
Impact:These data will be important in beginning to understand how vaccine risk perceptions can be altered when a vaccine is presented in a bioterrorism context. The studies are relevant for VA health care where optimized risk communications can enhance the likelihood that veterans will receive necessary vaccines and because it will be important to determine whether vaccines given in the event of a bioterrorism event can make existing distress worse or reduce vaccine effectiveness because of the stressfulness of the vaccination situation.