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Childhood vaccination: New research reveals that parents' decisions are based on knowledge, not bandwagon rumour

'MMR may be safe, but not for my child' is a common phrase amongst parents who have refused the jab. But far from being based on ignorance or rumour, parents make decisions on vaccination armed with knowledge and ideas specific to their child’s health, new research reveals.

Parents assess the risks and benefits of vaccines by focusing on ideas about their particular child’s immune system - discerned from issues as diverse as family illness history, the child’s strength, behaviour, allergies and diet. This child-specific focus affects how parents evaluate scientific controversy, reassurances about vaccine safety such as MMR and advice from health professionals.

And as vaccination is now an important topic of conversation among parents, discussions with friends and family are usually more influential than those with medical professionals, according to new research in Melissa Leach and James Fairhead’s book, Vaccine Anxieties: Global Science, Child Health and Society, published by Earthscan this week.

Leach and Fairhead argue that instead of dismissing parents’ anxieties about vaccinations such as the MMR jab as ignorant, irrational or based on rumour, doctors and policy makers must understand the logics of parents concerns if they are to communicate with them effectively.

Melissa Leach explains: “Our research with parents shows the strong logic that often underlies anxieties about vaccination. Yet experts often dismiss parents’ fears as based on ignorance or rumour, which leads to further problems. Unless new approaches to developing dialogue with parents, whether in European or African settings, are developed, the huge potential for vaccine technologies across the world will not be fully realised.”

Acknowledging each child’s needs has been encouraged as good parenting practice. Yet the policy of nurturing a nation of ‘informed patients’ has bitten back in the case of MMR, because mass childhood immunisation prefers docile parents. This contradiction is just one of many explored in Vaccine Anxieties.

By comparing several recent vaccine controversies - from public mistrust of the MMR jab in the UK to resistance to polio vaccination in Nigeria - Leach and Fairhead challenge common views about ignorance, risk, trust and rumour and suggest new ways to bridge the gap between science and society.

Based on detailed interviews and surveys covering thousands of parents in the UK and West Africa Leach and Fairhead argue that the diverse ways in which parents think about vaccines must be placed at the centre of policy debate if the opportunities of rapid technological advance in health are to be realised.

James Fairhead says: “Vaccine anxieties are about much more than just health. Building immunity has become pivotal to the way we think about our health, and our deliberations over vaccines. Yet in West Africa, building blood is at the heart of parental thinking. Interestingly, these core concepts also linked to how people understand society, economy and politics.”

Public mistrust of the triple MMR (measles, mumps and rubella) vaccine in the UK soared after Dr Andrew Wakefield claimed in 1998 that it was linked to autism and bowel disease. Uptake fell beneath 60% in some areas. Many scientists have since debunked Dr Wakefield’s claims but MMR remains controversial.

In Nigeria the UN’s polio eradication programme was derailed from 2003 when many Nigerians in the mostly-Muslim north refused to allow their children to be vaccinated, saying the anti-polio campaign was a conspiracy to sterilize Muslim children. Polio became resurgent.

Leach and Fairhead argue that large health campaigns can run in to problems when they by-pass trusted local health systems. When this happens, top-down campaigns are easily interpreted politically and create worry among the public, as was seen in Nigeria. Campaign and routine local health activity needs to be better integrated, they believe.

Increased access to vaccines is about more than getting the right health infrastructure in place, it is about understanding why people want vaccines and why they worry about them, say Leach and Fairhead.

Poor vaccination uptake should not be attributed to an ignorant, easily-misled public, but instead appreciating the diverse ways parents think about vaccines should be central to policy debate if vaccination technologies are to genuinely work.

Endorsements for Vaccine Anxieties:
“One of the most insightful and compelling analyses of a modern public health paradox.” Richard Horton, Editor of The Lancet

“A remarkable anthropological comparison across continents, this book is about common anxieties and different circumstances as they colour people’s lives. The empirical studies at its core show us parents struggling with global science, with stereotypes about ignorance, with the delivery of medical services, all framed by their personal knowledge and experiences. Vaccination offers a brilliant case study for a brilliant exposition.” Marilyn Strathern, DBE, Professor of Social Anthropology, University of Cambridge

“Is vaccination safe? Is resistance to MMR vaccine ignorant and wrong-headed? Leach and Fairhead offer provocative answers in this richly detailed account of how parents in the UK and West Africa cope with multiple anxieties in immunizing their children. This book should be compulsory reading for anyone concerned with global health and public policy.” Sheila Jasanoff, Pforzheimer Professor of Science and Technology Studies, John F. Kennedy School of Government, Harvard University

“This should be mandatory reading for everyone who believes that new vaccines and better vaccine coverage are fundamental to improving the health of children throughout the world – for without a better understanding of how vaccines are perceived by the parents whose children are being targeted these efforts will continue to encounter needless frustrations.” Sarah Rowland-Jones, Scientific Director, Medical Research Council Laboratories, The Gambia

Gudrun Freese | alfa
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