Healthy Trust and Pandemic Readiness in the Context of Messenger RNA Vaccines: Protocol for a Sequential Deliberative...

Pandemics threaten economies, security, and public health, requiring strong global and local collaboration and coordination. Public receptivity to emergent vaccine technologies is essential to pandemic readiness. Although messenger RNA (mRNA) vaccines offer rapid adaptability and hold promise, their use during the COVID-19 pandemic was met with polarizing debates that raise questions about the conditions needed to support acceptable and equitable use of new vaccines.

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 misinformation, disinformation, and malinformation. Using mRNA vaccines as a case study, the project's specific research objective is to seek insights into what people believe is needed for public understanding, equitable access, and acceptance of emerging vaccine technologies.

Using a sequential deliberative dialogue design, this study invites individuals with significant influence on pandemic readiness and those most likely to be disproportionately affected by related decisions into reflective, conversational, workshop-style online events and self-led dialogues. Dialogues and guiding questions are informed by a knowledge synthesis on what is unknown about mRNA vaccine public sentiments based on a rapid review, an environmental scan, consultations with experts across sectors, and ongoing updates from the dialogues. Data will be analyzed in situ in an iterative and collaborative synthesis of general agreements between dialogue contributors in response to guiding questions and emerging themes. Dialogue reports will be drafted by the research team based on observational notes, transcripts, and video recordings and reviewed by contributors. In summative dialogues, the research team will present main threads of dialogue, responding to research objectives and newly identified knowledge gaps and collecting input to inform dialogue outputs.

This study was funded in May 2025. As of June 2026, we have conducted 10 deliberative dialogues and supported 1 self-led dialogue, engaging 77 contributors across sectors and disciplines. We held 2 summative dialogues with 18 attendees, where we presented the main threads of dialogue as identified by the research team through collaborative analysis. We have started incorporating input from closing dialogues into the final reports and expect to publish the results in the second half of 2026, both as lay-language reports and peer-reviewed manuscripts.

This protocol outlines a consensus-building process capable of deepening the understanding of vaccine hesitancy and strengthening pandemic readiness and public trust in Canada. Dialogues are expected to provide general agreements on how to enhance science and health literacy, tailor communications considering historical inequities, respond to the needs of health care workers, and navigate polarization around vaccination. By creating space for shared learning and collective insight, this study supports the rebuilding of trust in public health institutions as they adapt to evolving societal expectations.