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Too much risk? Understanding childhood vaccination resistance in the UK
Abstract
Mass childhood immunisation (MCI) is of primary importance to all public health
systems. MCI in the UK is not a requirement for state school entry, as it is in the US,
but is still actively encouraged and promoted by the state. Recent media stories about
the safety of the MMR (measles, mumps, and rubella) vaccine have prompted
increased interest in this topic, and a government response that concentrates on
providing more risk information to the public. This policy is based on the assumption
that individuals make decisions through a comparison of risk calculations, and that
refusal to vaccinate is due to a public misunderstanding of risk. These assumptions are
in turn based on contentious models - a rational actor model of decision-making and
the ‘deficit model’ of the public understanding of science.
An analysis of UK and US organisations that are sceptical of vaccination reveals that
risk is not the only discourse used.
Questions are being asked which touch on
fundamental political tensions about the relationship between the individual and the
community, and between the community and the state. In addition, alternative
understandings of the basic biomedical categories of health and disease are expressed.
A policy response that focuses solely on risk may miss the significance of these
critiques. The paper suggests that the concept of ‘uncertainty’ may prove more useful
than risk for understanding responses to vaccination. Further social scientific research
is needed to understand the role that public trust plays in vaccination resistance and
acceptance.
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Convention