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Imagine you are in a restaurant enjoying a quiet dinner with friends when someone sneezes, spreading the influenza virus to the people around him.

That’s the beginning of an immersive virtual reality simulation that shows how flu spreads and impacts the health of other people. Researchers at ORAU and the University of Georgia hope such simulations will encourage more people to get a flu vaccine.

“When it comes to health issues, including flu, virtual reality holds promise because it can help people see the possible effects of their decisions, such as not getting a flu vaccine... Immersive VR increases our ability to give people a sense of what can happen if they do or don’t take a recommended action.”

The study, funded by an ORAU-Directed Research and Development grant, is the first published study to look at immersive VR as a communication tool for improving flu vaccination rates among “flu vaccine avoidant” 18-49-year-old adults.

Karen Carera, Ph.D., ORAU senior evaluation specialist, worked with Glen Nowak, Ph.D., principal investigator and director of the Center for Health and Risk Communication headquartered at UGA’s Grady College of Journalism and Mass Communication.

“When it comes to health issues, including flu, virtual reality holds promise because it can help people see the possible effects of their decisions, such as not getting a flu vaccine,” Nowak said. “In this study, we used immersive virtual reality to show people three outcomes – how, if infected, they can pass the flu on to others; what can happen when young children or older people get the flu; and how being vaccinated helps protect the person who is vaccinated as well as others. Immersive VR increases our ability to give people a sense of what can happen if they do or don’t take a recommended action.”

Carera explained that participants wore headsets and held game controllers during the VR experience, which took place in a restaurant where someone sneezed and the virus was spread to other people. The participants were shown that two people, a child and an older man, were taken to the hospital. Then the user was taken inside the body of someone infected with flu and they tried to fight the virus with antibodies. Participants used the game controller to “fire” at the virus. However, if the person in the VR simulation wasn’t vaccinated there weren’t enough antibodies to fight the virus; if they were vaccinated, participants saw what a difference it makes to fight the flu.

The VR simulation was designed to increase the influenza vaccination rate of adults aged 18-49, of which only 26.9 percent were vaccinated during the 2017-18 flu season, according to the Centers for Disease Control and Prevention.

“We really haven’t been able to move the adult vaccine rate,” Carera said, “so we wanted to look at another way we could involve people and have a more interactive experience rather than just having them read something on a sheet of paper.”

The 171 participants in this study self-identified as those who had not received a flu shot last year and did not plan to receive one during the 2017-18 influenza season. In the study, participants were randomly assigned to one of four groups: 1) a five-minute virtual reality experience; 2) a 5-minute video that was identical to the VR experience but without the 3-dimensional and interactive elements; 3) an e-pamphlet that used text and pictures from the video presented on a tablet computer; and 4) a control condition that only viewed the CDC’s influenza Vaccination Information Statement, which is often provided before a flu vaccine is given and describes benefits and risks. Participants in the VR, video and e-pamphlet conditions also viewed the CDC VIS before answering a series of questions regarding flu vaccination, including whether they would get a flu vaccine.

Nowak and Carera say the success of the immersive VR experience is that it gave participants a sense of “being there” or engagement in the story, which increased their concern about transmitting flu to others. And while the VR experience increased understanding of the need to get flu vaccination, a larger study is needed to test additional VR scenarios for their engagement rate with participants.  

“We would love the do the study with a larger number of people,” Carera said. She added that other areas to explore include using VR with parents of young children to see if their beliefs and behaviors regarding childhood vaccine could be influenced, as well as exploring other avenues of what may entice people to get their vaccinations.  

The research, “Using Immersive Virtual Reality to Improve the Beliefs and Intentions of Influenza Vaccine Avoidant 18- to 49-year-olds,” was published by the journal Vaccine on December 2, which falls during National Influenza Vaccination Week, Dec. 1 – 7, 2019. NIVW is a national awareness week focused on highlighting the importance of flu vaccination.

ORAU’s research team included Carera, Scott Hale and Deborah McFalls.