JMIR Publications

ABSTRACT

Background:

The first quarter of the twenty-first century was marked by significant infectious disease outbreaks, including two pandemics. Such events threaten economies, security, and public health, requiring strong global and local collaboration and coordination. In pandemic readiness efforts, public receptivity to emergent vaccine technologies is essential. Although mRNA vaccines offer rapid adaptability and hold considerable promise, their use during the COVID-19 pandemic generated intense and sometimes polarized debates. These tensions highlight critical questions about public trust, communication, and the conditions needed to support the acceptable and equitable use of new vaccine technologies.

Objective:

This deliberative dialogue study aims to generate consensus on how to ensure informed, accessible public engagement and strengthen public trust in a climate of divisiveness and mis/dis/mal-information. Using mRNA vaccines as a case study, the project seeks insights into what people believe is needed for public understanding, equitable access, and social acceptance of emerging vaccine technologies.

Methods:

Using a sequential deliberative dialogue design, this study invites people involved in the development, review, manufacturing and production, distribution, delivery, and uptake of mRNA vaccines into reflective, conversational workshop-style events. Given the influence of polarized social climates on trust, these workshop-style conversations will explore participants’ experiences and perspectives on the accessibility and acceptability of mRNA technology. The dialogue series includes exploratory conversations, targeted facilitated engagements, and opportunities for self-led dialogue using a toolkit, concluding with a summative dialogue. Target audiences include individuals with significant influence on pandemic readiness, as well as those most likely to be disproportionately affected by related decisions. This design aims to surface shared insights and areas of consensus across diverse experiences.

Results:

Deliberative dialogues will occur between December 2025 and March 2026 in Canada. Initial dialogues involving members of the larger research consortium are scheduled for December 2025 and January 2026. Participants have received a pre-dialogue brief, informed by a scoping review of the literature on mRNA vaccine hesitancy, covering themes like pandemic readiness, lessons from COVID-19, trust as a continuum, and tensions identified in the Canadian landscape. Each dialogue will inform subsequent engagements, contributing to a progressive, iterative understanding of barriers and facilitators to public trust and acceptance.

Conclusions:

This protocol outlines a consensus-building process designed to deepen understanding of vaccine hesitancy and strengthen pandemic readiness in Canada. Considering the significant harms associated with declining vaccine confidence - including recent measles resurgence - these dialogues aim to foster bridging conversations across groups with differing experiences and influence. By creating space for shared learning and collective insight, the study seeks to support the rebuilding of trust in public health institutions as they adapt to evolving societal expectations.