Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Hum Vaccin Immunother. 2021 Jul 3;17(7):2133-2144. doi: 10.1080/21645515.2020.1859318. Epub 2021 Feb 24.
: We aimed to elucidate public values regarding the use of genomics to improve vaccine development and use (vaccinomics).: 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.: 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.: 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.
: 我们旨在阐明公众对利用基因组学改善疫苗开发和使用（疫苗组学）的价值观。: 18 岁及以上的成年人通过社交媒体和社区组织招募，并随机分配到科罗拉多州博尔德和马里兰州巴尔的摩的四个嵌套讨论组之一。参与者在讨论疫苗组学之前和之后，对疫苗安全性和有效性的信心进行了评估。在离开之前，他们对疫苗组学与联邦优先事项（疫苗安全性和有效性、新疫苗和免费疫苗）和慢性病（癌症、心脏病和糖尿病）的资金进行了优先排序。受扎根理论影响的方法用于确定主题。: 参与者普遍支持疫苗组学。出现的主题：对隐私/机密性降低、基于遗传的污名/歧视增加以及通过基于遗传的优先级降低做出与疫苗相关决策的能力的担忧。参与者支持疫苗组学的个性化潜力。一些参与者在疫苗短缺期间赞成优先考虑他人而不是自己，而另一些则不赞成。一些参与者担心健康保险公司会根据疫苗组学发现的信息对他们进行歧视。参与者担心疫苗组学的不公平实施会导致弱势群体的歧视和边缘化。讨论疫苗组学并没有影响对疫苗安全性和有效性的看法。联邦对疫苗组学的资金广泛支持。: 参与者支持疫苗组学的个性化潜力，指出需要政策保障来促进公平实施和保护隐私。尽管存在一些担忧，但参与者希望疫苗组学能够提高疫苗的安全性和有效性。关于疫苗组学实施的政策必须解决公众对遗传信息的隐私和机密性的担忧，以及对疫苗组学收益的获取存在不平等的问题。
