Beyond Bites: A Sociocultural Probe into Lyme Vaccine Discourse and Prevention

Evaluating attitudes, beliefs, and behavioral intentions related to the Lyme disease vaccine


Shannon Cruz

Shannon Cruz

Assistant Professor
Communication Arts and Sciences
Erika Machtinger

Erika Machtinger

Associate Professor
Emily Struckhoff

Emily Struckhoff

Vector-Borne Disease Program Specialist
Malu Tejada

Maria Luisa Tejada

Extension Educator
Food Families and Communities


Lyme disease is the most common tick-borne disease in the United States, and Pennsylvania consistently ranks number one in annual cases. An estimated 476,000 people may be diagnosed with Lyme disease each year, affecting 1 out of every 100 people in Pennsylvania. Despite decades of work, methods for preventing Lyme disease are limited. Insect repellents and tick checks are the most common options. Yet the use of these methods is often low. Environmental tick control is another possibility, but costs and lack of community-based programs have impeded its adoption. Additional methods for protecting people against Lyme disease are needed.


One such method is a vaccine. But the Lyme disease vaccine has a complicated history. LYMERix, a human vaccine for Lyme disease, was available from 1998 to 2002. It was not readily accepted by the public due to reports that the vaccine caused arthritis and because the recommendations by public health agencies was tepid. While claims arthritis claims were unfounded, these issues resulted in low sales, a lawsuit against the pharmaceutical company, and the removal of the vaccine. Since then, no human vaccine for Lyme disease has been available. However, new Lyme disease vaccines are currently being developed, including VLA15, which is in phase 3 human clinical trials and has shown promising protection against Lyme disease.

Retrospective analyses of LYMERix emphasize the importance of effective messaging and public acceptance for any new vaccination efforts. With Lyme disease cases increasing each year, the successful launch of a vaccine is more crucial than ever and could have far-reaching public health implications. In particular, a vaccine against Lyme disease is one of the few methods shown to be effective at preventing the disease on a community scale. Given both the history of the vaccine and the rhetoric surrounding vaccination, however, little is known about how a new vaccine against Lyme disease will be received. Initial work on perceptions of a new vaccine has been limited, focusing primarily on baseline questions about whether someone would be vaccinated rather than deeper intentionality behind vaccination attitudes. No work has been done evaluating aspects of people’s identity, environment, or beliefs that may impact their decision to vaccinate for Lyme disease.


First, in partnership with the Penn State Survey Research Center, we will be conducting focus groups with residents across the state, emphasizing reaching rural populations and people who may be occupationally or recreationally at high risk of the disease (e.g., hunters). Second, recent work in communication has emphasized that a complete understanding of message effects requires an understanding of both intra-attitude networks—the structure of connections among beliefs, feelings, and evaluations toward a single topic—and inter-attitude networks—the structure of connections among attitudes toward different topics. Understanding how vaccine-focused messaging may impact other attitudes and related behaviors, such as wearing insect repellents and doing tick checks, will be vital for understanding the broader effects of messages on community health practices—positive or negative.


Currently, the group is working to recruit participants for conducting focus groups.