In attempting to provide protection to individuals and communities, childhood immunization has benefits that far outweigh disease risks. However, some parents decide not to immunize their children with some or all vaccines for reasons including lack of trust in governments, health professionals, and vaccine manufacturers. This article employs a theoretical analysis of trust and distrust to explore how twenty-seven parents with a history of vaccine rejection in two Australian cities view the expert systems central to vaccination policy and practice. Our data show how perceptions of the profit motive generate distrust in the expert systems pertaining to vaccination. Our participants perceived that pharmaceutical companies had a pernicious influence over the systems driving vaccination: research, health professionals, and government. Accordingly, they saw vaccine recommendations in conflict with the interests of their child and “the system” underscored by malign intent, even if individual representatives of this system were not equally tainted. This perspective was common to parents who declined all vaccines and those who accepted some. We regard the differences between these parents—and indeed the differences between vaccine decliners and those whose Western medical epistemology informs reflexive trust—as arising from the internalization of countering views, which facilitates nuance.
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The Fremantle data was gathered by Katie Attwell while working for the Immunisation Alliance of Western Australia, a not-for-profit immunization advocacy organization. The Alliance received funding from Sanofi Pasteur in the form of a $20,000 unrestricted grant to develop and evaluate the “I Immunise” campaign, which itself was funded by the Department of Health, Western Australia. Neither external organization contributed to the study design; data collection, analysis, interpretation, or writing, nor did they influence manuscript submission decisions. The data collection in South Australia was funded by the Flinders Medical Centre Foundation as a Seeding Grant, with no input into the decisions and processes outlined above. Julie Leask receives funding from the Australian Government Department of Health and the National Centre for Immunisation Research and Surveillance for research in addressing vaccine hesitancy. She is in receipt of an NHMRC Career Development Fellowship.
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Attwell, K., Leask, J., Meyer, S.B. et al. Vaccine Rejecting Parents’ Engagement With Expert Systems That Inform Vaccination Programs. Bioethical Inquiry 14, 65–76 (2017). https://doi.org/10.1007/s11673-016-9756-7
- Vaccine hesitancy