Shafquat Madiha, Patel Niyati, McFadden Brandon, Stark James H, Gould L Hannah
Vaccines and Antivirals Medical Affairs, Pfizer US Commercial Division, Cambridge, MA, United States.
Behavioralize LLC, Wynnewood, PA, United States.
Front Public Health. 2025 Mar 21;13:1473304. doi: 10.3389/fpubh.2025.1473304. eCollection 2025.
Lyme disease (LD) incidence in the United States is highly regional, with most cases occurring in 16 high-incidence jurisdictions. LD incidence and severity of disease have been found to vary by race. This study describes racial differences in knowledge, attitudes toward vaccination, and risk practices related to LD.
Four web-based surveys were conducted with adults and caregivers of children in high-incidence jurisdictions and 10 states neighboring them. Respondents were recruited via an established online panel to represent the general population. Self-reported race was pooled into 3 categories: 'White', 'Black or African American', and 'Other' for analysis. Analyses were conducted separately for each jurisdiction (high-incidence vs. neighboring) and respondent type (adult vs. caregiver).
The final sample across all surveys included 2,249 respondents who identified as White, 493 respondents who identified as Black or African American, and 674 respondents of other races. White respondents were older, had higher incomes, and were likelier to live in small cities and rural areas. Though attitudes toward vaccination in general were similar between racial categories, when differences were present, Black respondents were more likely to have concerns about vaccines than White respondents. In all surveys, White respondents engaged in more outdoor activities than Black respondents and performed these activities more often. However, both White adults and caregivers in high-incidence jurisdictions were significantly less likely to have occupations with primarily outdoor work than corresponding respondents in other racial groups. Black respondents also had lower knowledge about LD than White respondents across all surveys. This difference was significant after adjusting for state incidence level and urbanicity.
There are some racial differences in knowledge, attitudes, and practices around LD, with White respondents reported having higher knowledge of LD, less concerns about vaccines, and higher frequency of risk practices. These differences might contribute to racial disparities in LD outcomes.
美国莱姆病（LD）的发病率具有高度的地区性，大多数病例发生在16个高发病率辖区。研究发现，莱姆病的发病率和疾病严重程度因种族而异。本研究描述了在与莱姆病相关的知识、对疫苗接种的态度以及风险行为方面的种族差异。
对高发病率辖区及其周边10个州的成年人和儿童看护者进行了四项基于网络的调查。通过一个既定的在线小组招募受访者以代表一般人群。自我报告的种族被汇总为3类：“白人”、“黑人或非裔美国人”和“其他”用于分析。针对每个辖区（高发病率辖区与周边辖区）和受访者类型（成年人与看护者）分别进行分析。
所有调查的最终样本包括2249名自认为是白人的受访者、493名自认为是黑人或非裔美国人的受访者以及674名其他种族的受访者。白人受访者年龄更大，收入更高，更有可能居住在小城市和农村地区。尽管不同种族对疫苗接种的总体态度相似，但存在差异时，黑人受访者比白人受访者更可能对疫苗存在担忧。在所有调查中，白人受访者比黑人受访者参与更多的户外活动，且进行这些活动的频率更高。然而，高发病率辖区的白人成年人和看护者从事主要户外工作的职业可能性明显低于其他种族的相应受访者。在所有调查中，黑人受访者对莱姆病的了解也低于白人受访者。在调整了州发病率水平和城市化程度后，这种差异仍然显著。
在莱姆病的知识、态度和行为方面存在一些种族差异。据报告，白人受访者对莱姆病的了解更高，对疫苗的担忧更少，且风险行为的频率更高。这些差异可能导致莱姆病结果方面的种族差异。
