Understanding Consumer and Clinician Perceptions of a Potential Lyme Disease Vaccine

Theoretical Background and research questions/hypothesis:

Lyme disease was the sixth most common nationally notifiable infectious disease in 2015 with over 38,000 cases reported to CDC. Lyme disease is a complex—and sometimes contentious—disease, and current preventive measures have not proven to be sufficient in stemming rising incidence. An effective human Lyme disease vaccine could be a powerful intervention for population level impact.

In advance of new Lyme disease vaccines coming to market, CDC’s Division of Vector-Borne Diseases engaged Hager Sharp to conduct qualitative research among groups who may potentially benefit from the vaccine and certain clinician groups who may provide the vaccine. The aim was to explore barriers to and facilitators for acceptability and uptake of a new Lyme disease vaccine as associated with the Health Belief Model, which suggests that preventive health behaviors, like vaccination, are linked to perceptions of susceptibility to a disease, the severity of the disease, the benefits and barriers to acting, and motivators to act.

Methods:

We recruited clinician participants (n = 30) across seven professional categories for telephone in-depth interviews and consumers (n=35) across three consumer categories for nine online focus groups (2–5 consumers per group). All participants were recruited from three regions of high Lyme disease incidence: Northeast, Mid-Atlantic, and Upper Midwest.

Results:

Eighty-three percent of clinicians reported they would likely recommend the vaccine, and 71% of consumers reported that they would likely get the vaccine for themselves or their families. On a scale of 1 to 4 (1=not at all severe, 4 = severe), clinicians rated the severity of Lyme disease at an average of 2.87, compared to clinicians’ estimates of their patients’ perceived severity at an average of 3.35 and consumers’ own reported average severity rating of 3.30. Participants shared common motivators to either recommending or accepting a Lyme disease vaccine, largely driven by perceived benefits of the vaccine, lack of current preventive measures, and greater peace of mind. Barriers included concerns about vaccine safety, consumer misinformation or knowledge gaps, lower prioritization of a Lyme disease vaccine compared to other vaccines or other preventive measures, and logistical barriers (e.g., cost, lack of insurance coverage for the vaccine).

Conclusions:

Most consumers and clinicians in endemic areas were supportive of a vaccine and would either likely recommend it (clinicians) or be likely to receive it (consumers). Consumers and clinicians in the Northeast, Upper Midwest, and Mid-Atlantic have high awareness and concern (i.e., perceived susceptibility and severity) about Lyme disease, creating an opportunity to provide education and promotion about Lyme disease prevention, including a vaccine. Concern about getting Lyme disease is a primary motivator for consumers wanting the vaccine, while concern about the challenges associated with diagnosing and treating Lyme disease is a primary motivator for clinicians recommending the vaccine.

Implications for research and/or practice:

Exploring vaccine perceptions from both consumer and clinician perspectives can provide a more holistic view of the potential constraints or supports for vaccine success and can inform communication and marketing efforts targeting both audiences.