Ethical and policy implications of vaccinomics in the United States: community members' perspectives

doi:10.1080/21645515.2020.1859318

Randomized Controlled Trial

. 2021 Jul 3;17(7):2133-2144.

doi: 10.1080/21645515.2020.1859318. Epub 2021 Feb 24.

Ethical and policy implications of vaccinomics in the United States: community members' perspectives

Jennifer E Gerber¹, Janesse Brewer¹, Rupali J Limaye^{1

2

3

4

5}, Andrea Sutherland¹, Gail Geller^{4

6

7

8}, Christine I Spina⁷, Daniel A Salmon^{1

2

4

9

10}

Affiliations

¹ Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
² Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
³ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
⁴ Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public, Baltimore, MD, USA.
⁵ International Vaccine Access Center, International Vaccine Access Center, Baltimore, MD, USA.
⁶ Department of Medicine, Johns Hopkins School of Medicine.
⁷ Department of Health Policy, Johns Hopkins Bloomberg School of Public, Baltimore, MD, USA.
⁸ Berman Institute of Bioethics, Deering Hall, Baltimore, MD, USA.
⁹ Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
¹⁰ Children's Hospital Colorado, Aurora, CO, USA.

PMID: 33626296
PMCID: PMC8189107
DOI: 10.1080/21645515.2020.1859318

Randomized Controlled Trial

Ethical and policy implications of vaccinomics in the United States: community members' perspectives

Jennifer E Gerber et al. Hum Vaccin Immunother. 2021.

. 2021 Jul 3;17(7):2133-2144.

doi: 10.1080/21645515.2020.1859318. Epub 2021 Feb 24.

Authors

Jennifer E Gerber¹, Janesse Brewer¹, Rupali J Limaye^{1

2

3

4

5}, Andrea Sutherland¹, Gail Geller^{4

6

7

8}, Christine I Spina⁷, Daniel A Salmon^{1

2

4

9

10}

Affiliations

¹ Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
² Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
³ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
⁴ Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public, Baltimore, MD, USA.
⁵ International Vaccine Access Center, International Vaccine Access Center, Baltimore, MD, USA.
⁶ Department of Medicine, Johns Hopkins School of Medicine.
⁷ Department of Health Policy, Johns Hopkins Bloomberg School of Public, Baltimore, MD, USA.
⁸ Berman Institute of Bioethics, Deering Hall, Baltimore, MD, USA.
⁹ Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
¹⁰ Children's Hospital Colorado, Aurora, CO, USA.

PMID: 33626296
PMCID: PMC8189107
DOI: 10.1080/21645515.2020.1859318

Abstract

Objectives: We aimed to elucidate public values regarding the use of genomics to improve vaccine development and use (vaccinomics).Methods: Adults ≥18 years-old were recruited through social media and community organizations, and randomly assigned to one of four nested discussion groups in Boulder, CO and Baltimore, MD. Participants rated their confidence in vaccine safety and effectiveness prior to and after discussing vaccinomics. Before departing, they prioritized funding for vaccinomics versus federal priorities (vaccine safety and efficacy, new vaccines, and free vaccines) and chronic diseases (cancer, heart disease, and diabetes). Grounded Theory-influenced methods were used to identify themes.Results: Participants broadly supported vaccinomics. Emergent themes: concerns about reduced privacy/confidentiality, increased genetically based stigma/discrimination, and reduced agency to make vaccine-related decisions through genetically based prioritization. Participants supported vaccinomics' potential for increased personalization. Some participants favored prioritizing others over themselves during a vaccine shortage, while others did not. Some participants worried health insurance companies would discriminate against them based on information discovered through vaccinomics. Participants feared inequitable implementation of vaccinomics would contribute to discrimination and marginalization of vulnerable populations. Discussing vaccinomics did not impact perceptions of vaccine safety and effectiveness. Federal funding for vaccinomics was broadly supported.Conclusion: Participants supported vaccinomics' potential for increased personalization, noting policy safeguards to facilitate equitable implementation and protect privacy were needed. Despite some concerns, participants hoped vaccinomics would improve vaccine safety and effectiveness. Policies regarding vaccinomics' implementation must address public concerns about the privacy and confidentiality of genetic information and potential inequities in access to vaccinomics' benefits.

Keywords: Genomics; Infectious disease; Vacccinomics; Vaccines; Values.

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Figures

**Figure 1.**
Data collection procedures

**Figure 3.**
Vaccine-related funding priorities

**Figure 4.**
Chronic disease-related funding priorities

See this image and copyright information in PMC

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Gerber JE, Brewer J, Limaye RJ, Sutherland A, Blunt M, Holroyd TA, Geller G, Carleton B, Kahn J, Salmon DA. Gerber JE, et al. Hum Vaccin Immunother. 2021 Sep 2;17(9):2999-3015. doi: 10.1080/21645515.2021.1911217. Epub 2021 Jun 21. Hum Vaccin Immunother. 2021. PMID: 34152932 Free PMC article.
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References

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1. Dhakal S, Klein SL, Coyne CB. Host factors impact vaccine efficacy: implications for seasonal and universal influenza vaccine programs. J Virol. 2019;93(21). doi:10.1128/JVI.00797-19. - DOI - PMC - PubMed
1. Klein SL, Marriott I, Fish EN. Sex-based differences in immune function and responses to vaccination. Trans R Soc Trop Med Hyg. 2015;109(1):9–15. doi:10.1093/trstmh/tru167. - DOI - PMC - PubMed
1. Halsey NA, Griffioen M, Dreskin SC, Dekker CL, Wood R, Sharma D, Jones JF, LaRussa PS, Garner J, Berger M, et al. Immediate hypersensitivity reactions following monovalent 2009 pandemic influenza A (H1N1) vaccines: reports to VAERS. Vaccine. 2013;31(51):6107–12. doi:10.1016/j.vaccine.2013.09.066. - DOI - PubMed
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[1] Poland GA, Kennedy RB, McKinney BA, Ovsyannikova IG, Lambert ND, Jacobson RM, Oberg AL.. Vaccinomics, adversomics, and the immune response network theory: individualized vaccinology in the 21st century. Semin Immunol. 2013;25(2):89–103. doi:10.1016/j.smim.2013.04.007. - DOI - PMC - PubMed

[2] Poland GA, Kennedy RB, McKinney BA, Ovsyannikova IG, Lambert ND, Jacobson RM, Oberg AL.. Vaccinomics, adversomics, and the immune response network theory: individualized vaccinology in the 21st century. Semin Immunol. 2013;25(2):89–103. doi:10.1016/j.smim.2013.04.007. - DOI - PMC - PubMed

[3] Dhakal S, Klein SL, Coyne CB. Host factors impact vaccine efficacy: implications for seasonal and universal influenza vaccine programs. J Virol. 2019;93(21). doi:10.1128/JVI.00797-19. - DOI - PMC - PubMed

[4] Dhakal S, Klein SL, Coyne CB. Host factors impact vaccine efficacy: implications for seasonal and universal influenza vaccine programs. J Virol. 2019;93(21). doi:10.1128/JVI.00797-19. - DOI - PMC - PubMed

[5] Klein SL, Marriott I, Fish EN. Sex-based differences in immune function and responses to vaccination. Trans R Soc Trop Med Hyg. 2015;109(1):9–15. doi:10.1093/trstmh/tru167. - DOI - PMC - PubMed

[6] Klein SL, Marriott I, Fish EN. Sex-based differences in immune function and responses to vaccination. Trans R Soc Trop Med Hyg. 2015;109(1):9–15. doi:10.1093/trstmh/tru167. - DOI - PMC - PubMed

[7] Halsey NA, Griffioen M, Dreskin SC, Dekker CL, Wood R, Sharma D, Jones JF, LaRussa PS, Garner J, Berger M, et al. Immediate hypersensitivity reactions following monovalent 2009 pandemic influenza A (H1N1) vaccines: reports to VAERS. Vaccine. 2013;31(51):6107–12. doi:10.1016/j.vaccine.2013.09.066. - DOI - PubMed

[8] Halsey NA, Griffioen M, Dreskin SC, Dekker CL, Wood R, Sharma D, Jones JF, LaRussa PS, Garner J, Berger M, et al. Immediate hypersensitivity reactions following monovalent 2009 pandemic influenza A (H1N1) vaccines: reports to VAERS. Vaccine. 2013;31(51):6107–12. doi:10.1016/j.vaccine.2013.09.066. - DOI - PubMed

[9] Griffioen M, Halsey N. Gender differences in immediate hypersensitivity reactions to vaccines: a review of the literature. Public Health Nurs. 2014;31(3):206–14. doi:10.1111/phn.12073. - DOI - PubMed

[10] Griffioen M, Halsey N. Gender differences in immediate hypersensitivity reactions to vaccines: a review of the literature. Public Health Nurs. 2014;31(3):206–14. doi:10.1111/phn.12073. - DOI - PubMed

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Ethical and policy implications of vaccinomics in the United States: community members' perspectives

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Ethical and policy implications of vaccinomics in the United States: community members' perspectives

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Medical