Background: Policy decisions about childhood vaccination require consideration of multiple, sometimes conflicting, public health and ethical imperatives. Examples of these decisions are whether vaccination should be mandatory and, if so, whether to allow for non-medical exemptions. In this article we argue that these policy decisions go beyond typical public health mandates and therefore require democratic input. Methods: We report on the design, implementation, and results of a deliberative public forum convened over four days in Ontario, Canada, on the topic of childhood vaccination. Results: 25 participants completed all four days of deliberation and collectively developed 20 policy recommendations on issues relating to mandatory vaccinations and exemptions, communication about vaccines and vaccination, and AEFI (adverse events following immunization) compensation and reporting. Notable recommendations include unanimous support for mandatory childhood vaccination in Ontario, the need for broad educational communication about vaccination, and the development of a no-fault compensation scheme for AEFIs. There was persistent disagreement among deliberants about the form of exemptions from vaccination (conscience, religious beliefs) that should be permissible, as well as appropriate consequences if parents do not vaccinate their children. Conclusions: We conclude that conducting deliberative democratic processes on topics that are polarizing and controversial is viable and should be further developed and implemented to support democratically legitimate and trustworthy policy about childhood vaccination.the Author(s). published with license by taylor & Francis Group, llc.

Public deliberation is a form of dialogue that allows members of the public to provide input on a policy issue. Public deliberation processes invite participants to engage with each other respectfully, learn about the topic and each other's perspectives, and then work together toward solutions to an issue that are broadly acceptable. In this article, we develop a discursive psychological analysis of public deliberation on the topic of childhood vaccination. In particular, we focus on how descriptions of a parent who did not have her children vaccinated were developed iteratively by a small group of deliberants; how these descriptions came to be accepted as factual; and how these descriptions came to be used to support normative claims about childhood vaccination. Our main argument is that we can develop a deeper understanding of deliberation processes if we understand participants' statements to be rhetorically organised. This is achieved by examining how descriptions of events or people that are relevant to the final conclusions of the group are developed in the course of deliberation; how they come to be accepted as factual and accurate by the group; and how they then become instrumental in supporting a final consensus position.