In this segment of my health communication blog series, I will summarize the findings of a meta-analysis that aims to examine parents’ opinions on child vaccinations.* The goal of this publication is to better understand how and why these opinions are formed. With their data the authors wish to challenge the idea that parents’ views on vaccination is polarized into pro and anti vaccine groups. Instead they argue that this polarized view is wrong and alienates multiple other opinions and perspectives that shape parents’ vaccination decisions. The authors found that a parent’s view on vaccines is “context-specific” meaning that personal experience, the child’s needs, and a parent’s social environment are factors that can influence a parent’s choice. I chose to summarize this meta-analysis due to its insightful analysis helping readers to understanding the discourse around vaccines.
A background on vaccinations and the discussion around it
When one gets a vaccination, one is exposed to a weaker form of a pathogen, which will produce an immune responses. The immune system will fight off the pathogen in the vaccine and thereby forms a memory of the encounter. This primes the immune system to launch a massive response if an individual comes in contact with the same pathogen again, thus providing protection against illness.
When a whole population is vaccinated , this creates “herd immunity”. Herd immunity reduces an individual’s chance of catching a disease because others are immune to the disease and are less likely to carry it. While there is evidence supporting the effectiveness of vaccination, there are side effects to the vaccines that don’t make them 100% safe. These side effects can range from minor symptoms such as redness at the sight of injection, or severe reactions such as seizures, a low platelet count or allergic reactions that result in brain damage. There are also other, self reported side effects, such as autism and multiple sclerosis (MS), but there is little medical research that proves such a connection exists. This article demonstrates when expressing skepticism against vaccination, not all parents cite autism or MS as reasons for supporting their views. However, mainstream conversation around vaccine hesitancy largely connects autism and MS with parents who refuse vaccination for their children. This is not a realistic view of the range of reasons parents provide for their vaccination decisions.
How health institutions form the discourse around vaccinations
The authors propose that the public’s view on vaccinations is a construct of advertisements and outreach efforts composed by pharmaceutical companies, health care providers and scientists. Usually, the message conveyed to the public is in favor of childhood vaccinations and medical institutions use specific strategies and concepts to argue their point. A frequently used concept is presenting vaccines as ways to escape the risk of a vaccine preventable diseases (VPD). Health institutions also use quantitative data to argue for the necessity of vaccines. An example of this is how the CDC compared the number of VPD cases before the development of a particular vaccine, and after it was developed and used to immunize children. Another approach has been through providing personal accounts of parents and health care providers who have had experience with VPD. This account can contain visuals, and testimonials that aim to get an emotional reaction from the audience and persuade them to vaccinate their children. The pro-vaccine agenda is also promoted through state policies that mandate vaccination in all states. But while these mandates are in place there are ways to circumvent a vaccination based on certain medical, religious or philosophical exemptions.
How social science views the discourse around vaccinations
In this analysis the authors take a social science route. They break down why parents are afraid to risk a child’s health on a vaccine and why they want control over their children’s health. The authors state that instead of thinking about the stereotypical polarized debate around vaccines, we must consider that each parent will interpret statistics and facts on vaccines based on their own personal experiences and interpretations. They also invite us to view vaccine hesitancy from the point of view of risk production: a modern tendency to avoid accidents and sickness. The authors argue that the root of parents’ decisions may be due to a desire to have control over their lives and the well-being of their children.
This meta analysis explored three studies on how three west coast populations viewed childhood vaccinations. The first population was a community in King County, Washington and the study conducted interviews inquiring about how parents made their vaccination decisions and the factors that influence these decisions. For the second population, based in San Diego, the researchers had the parents participate in focus groups, formative interviews and cognitive interviews in which they were asked about general health issues like nutrition, screen time, and outdoor time. The last group, also parents based in San Diego, interviews were conducted on vaccine decision making. The findings gleaned from these studies gave insight to the parents’ perceptions of childhood vaccinations.
Parents want what’s best for their child
Regardless of whether the parents were anti or pro vaccine, all expressed that they were doing what they thought was best for their children. In some cases, parents thought that a complete vaccination was in the child’s best interest, while others viewed forgoing vaccines was the best path for their child. For the latter, parents saw that the risk of vaccines was too much to place on their child, and depending on the child, they didn’t see vaccines as the best course of action. In summary, opinions aside, one factor affecting parents decisions is what they deemed is best for their child.
Vaccine Risk is specialized
The authors also gleaned from the study that each child has an individualized risk, which leads the parents to take a specific stance on vaccines. Specific factors that can influence a parent’s view can be the child’s age, health history, genetic background and present health status. Regardless of whether vaccines are beneficial or not, the authors point out that context is an important influence on a parent’s decision, even if a parent views vaccines as beneficial, their child can have specific health concerns that changes their view toward vaccinations.
Risks related to the vaccines in general
Parents also expressed concern about vaccine ingredients , vaccination schedules and the unknowns about vaccines. Regarding the vaccine ingredients, participants worried about additives such as mercury and aluminum and possible effects they could have to the “body’s existing biochemical or macrobiotic balance”. Parents were also concerned about the timing of the vaccines and how, at a young age, vaccines are administered concurrently. In addition, parents have increasing anxiety about concurrent vaccination because their continues to be a lack of research regarding the topic. Lastly, the authors point out that some, worry about the “unknowns” of vaccines. Specifically, a participant worried about not knowing the effects of vaccines and asked her partner, “what if”. All of these risks and unknowns about vaccines can cause doubts in parents’ minds and as a result, parents are left worrying over their child’s well being.
Risks can be socially and situationally influenced
The parents’ view on vaccines is also influenced by situational factors. Their life experience and social interactions can affect how they see the risks and benefits of vaccines. The authors discovered that if the participants had first hand experiences with an adverse effect related to vaccination or vaccine preventable diseases, this can have a direct impact on their vaccination decisions. Parents’ vaccination views are also influenced by their social setting and the sources of information about vaccines, such as friends, family and even the internet.
The findings that were derived from these three sets of data are crucial for understanding the many reasons parents decide to vaccinate or not vaccinate their children. As the analysis states, not all parents are either pro or anti vaccines because the context of a child’s health is crucial to determining a parent’s vaccination decision. This article aids in depolarizing the discourse around vaccines by revealing a “high degree of variability” in how families view vaccines and the reasons behind their vaccination decisions. It also erases the “shortsightedness” of stereotyping a possibly complex and personalized situation into the two generalized groups of anti and pro vaccines. The authors urge us not to classify all parents skeptical of vaccination as anti-vaccine, as there is a spectrum of views and approaches to this issue among parents.
*Brunson, Emily K., and Elisa J. Sobo. “Framing childhood vaccination in the united states: getting past polarization in the public discourse.” Human Organization 76.1 (2017): 38-47.
Parents are often classified into two camps: pro-vaccine and anti-vaccine. The reality is more nuanced as parents’ views are diverse and context dependent.