Citation

Weitzman ER, Kossowsky J, Blakemore LM, Cox R, Dowling DJ, Levy O, Needles EW, Levy S. Clin. Infect. Dis. 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, University of Chicago Press)

DOI

10.1093/cid/ciac344

PMID

unavailable

Abstract

The opioid epidemic worsened during the COVID-19 pandemic. Synthetic opioids (primarily fentanyl) comprise the most common drugs involved in overdose (OD) death. A vaccine that blocks fentanyl from reaching the brain to prevent OD is under development and insight is needed into its acceptability.Using a semi-structured interview guide, persons with opioid use disorder (OUD), family, professionals, and the public, were interviewed about attitudes and concerns regarding a fentanyl vaccine. Reactions to fictional clinical vignettes of persons at risk of OUD because of pain and/or substance use histories were collected, analyzed, and quantified for favorability. Interviews were transcribed, coded, and analyzed thematically.Among N = 64 participants, (70.3% female, average age 32.4 years), attitudes were favorable toward a fentanyl vaccine, with preference for lifelong durability (76% of n = 55 asked). Perceived benefits centered on the potential for a life-saving intervention, suffering averted, healthcare dollars saved, and the utility of a passive harm reduction strategy. Concerns centered on uncertainty regarding vaccine safety, questions about efficacy, worry about implications for future pain management, stigma, and need for supportive counseling and guidance to personalize decision-making. Reactions to vignettes revealed complex attitudes towards fentanyl vaccination when considering recipient age, health history, and future risks for addiction and pain.Positive responses to a fentanyl vaccine were found along with appreciation for the complexity of a vaccine strategy to prevent OD in the setting of pain and uncertain durability. Further research is needed to elucidate operational, ethical, and communications strategies to advance the model.

Language: en