Vaccine hesitancy among adults living with allergy

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Supervisory Team Director of Studies: Dr Béré Mahoney, School of Health and Wellbeing and Three Counties Medical School, University of Worcester Supervisors: Dr Richard Clarke, School of Education and Sciences, University of Gloucestershire, Cheltenham Advisors:Mr Stephen O’Hickey, Consultant in Respiratory Medicine with Worcestershire Acute NHS Hospitals.

Research Group: Living Well with Long-Term Conditions

The PhD Opportunity: The global spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV- 2) brought the impact of vaccine-related hesitancy on healthcare planning and delivery into sharp focus (Clark et al, 2025). Concern is growing about mRNA vaccine-related hesitancy beyond COVID-19 vaccines (Xu et al, 2024) given their wide-ranging application including disease prevention, and curative therapies for cancers (Li et al, 2023; Rzymski et al, 2023).

Vaccine hesitancy is studied widely but the role of allergies in shaping vaccine concerns is less explored, particularly in the context of mRNA vaccines (Larson, 2024). Hesitancy may be heightened among adults living with allergy given perceived or actual risks associated with vaccination can appear greater to these individuals than the risks posed by the disease (Li et al, 2021). This dynamic reflects the known interplay of risk perception, cognitive biases (e.g. omission bias, availability heuristic, conformation bias), and attitudinal drivers of vaccine hesitancy that could be heightened among individuals with allergies, amplifying fears and distorting risk perceptions (Brown et al, 2010; DiBonaventura et al, 2008; Soni et al, 2021). Addressing these psychological drivers is essential for reducing vaccine hesitancy, particularly in populations with heightened concerns about allergic reactions.

Aims

We seek to recruit several PhD students to investigate vaccine-related hesitancy among adults who are living with allergy that is either clinically or self, diagnosed. Projects should explore these adults’ vaccine-related experiences and decision- making, and the impact of their allergy on how they access healthcare and their health-related help-seeking. Students are encouraged to consider these issues in the context of primary health care but may choose to focus on a sub-set of adults living with allergy or a specific vaccination programmes. PhD Opportunity

Vaccine hesitancy among adults living with allergy

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Methods Quantitative methods, qualitative methodologies or a mixed research approach with primary and/or secondary data may be used. Approaches that enable capture of the role of allergy in adults’ engagement with healthcare (e.g. help-seeking, uptake of health checks and routine surveillance programmes) are encouraged.

References • Clarke, R. M., O’Hickey, S. P., Walklet, E., Bradley, E., & Mahoney, B. (2025). Managing allergy-related COVID-19 vaccine hesitancy: A multi-methods analysis of practitioner notes and referral outcomes. Human Vaccines & Immunotherapeutics, 21(1), 2561457. • Brown, K. F., Kroll, J. S., Hudson, M. J., Ramsay, M., Green, J., Vincent, C. A., ... & Sevdalis, N. (2010). Omission bias and vaccine rejection by parents of healthy children: implications for the influenza A/H1N1 vaccination programme. Vaccine, 28(25), 4181-4185. • DiBonaventura, M. D., & Chapman, G. B. (2008). Do decision biases predict bad decisions? Omission bias, naturalness bias, and influenza vaccination. Medical Decision Making, 28(4), 532-539. • Larson, H. J. (2024). Understanding vaccine hesitancy: A call for more social science in RNA vaccine research. Vaccine Insights, 3, 107-110. • Li L, Robinson LB, Patel R, Landman AB, Fu X, Shenoy ES, Hashimoto DM, Banerji A, Wickner PG, Samarakoon U, Mancini CM, Zhang Y, Blumenthal KG. Association of Self-reported High-Risk Allergy History With Allergy Symptoms After COVID-19 Vaccination. JAMA Netw Open. 2021 Oct 1;4(10):e2131034. doi: 10.1001/jamanetworkopen.2021.31034. PMID: 34698847; PMCID: PMC8548941. • Li, Y., Wang, M., Peng, X., Yang, Y., Chen, Q., Liu, J., ... & Li, X. (2023). mRNA vaccine in cancer therapy: Current advance and future outlook. Clinical and translational medicine, 13(8), e1384. • Rzymski, P., Szuster‐Ciesielska, A., Dzieciątkowski, T., Gwenzi, W., & Fal, A. (2023). mRNA vaccines: The future of prevention of viral infections?. Journal of Medical Virology, 95(2), e28572. • Soni S., Bleichrodt, H. Biases and heuristics underlying vaccine hesitancy. 2021 May 30. doi: 10.13140/RG.2.2. 15358.05441. • Xu, J., Wu, Z., Wass, L., Larson, H. J., & Lin, L. (2024). Mapping global public perspectives on mRNA vaccines and therapeutics. npj Vaccines, 9(1), 218.

Application Process: To begin the application process please go to https://www.worc.ac.uk/research/research-degrees/applying-for-a-phd/.

The Interview: All successful applicants will be offered an interview with the proposed Supervisory Team. You will be contacted by a member of the Doctoral School Team to find a suitable date. Interviews can be conducted in person or over Microsoft Teams.

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Funding your PhD For information about Doctoral Loans please visit: https://www.worc.ac.uk/study/fees- and-finance/doctoral-loans.aspx

During your PhD you can access the Research Conference Support Scheme to support the costs of presenting your research at an external conference.

Research at the University of Worcester Research is central to the University’s mission to make a difference in everything that we do. We are committed to delivering excellent research which extends the boundaries of human knowledge but which also improves people’s lives by enabling better health outcomes, improving food security, developing environmentally sustainable solutions for crop production and socially sustainable solutions to our ageing population, enhancing public knowledge and understanding of the past and present.

The University hence focuses its research around five high-level challenges facing society, locally, nationally and globally:

• Human Health and Wellbeing • Sustainable Futures • Digital Innovation • Culture, Identity and Social Exclusion • Professional Education

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It provides:

• day-to-day support for our students, both administrative and practical, through our dedicated team • a Research Student Study Space with both PCs and laptop docking station • a comprehensive Researcher Development Programme for students and their

supervisors

• a programme of student-led conferences and seminars

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Widening Participation As part of its mission statement the University is committed to widening participation for its higher degrees. Although most candidates will have an undergraduate and/or a Masters degree, the University is happy to accept applications from candidates with relevant professional qualifications and work related experience.

For further information or an informal discussion on this project, please contact Dr Bere Mahoney b.mahoney@worc.ac.uk

Research areas