Between individualism and social solidarity in vaccination policy: the case of the 2013 OPV campaign in Israel

Abstract

Background: During the summer of 2013, after samples of poliomyelitis virus were found in sewage, Israel launched an intensive national oral polio vaccine (OPV) campaign. The clinical objective of the campaign was rather clear. With not a single case of infantile paralysis and with a population already highly protected with IPV (a dead version of the vaccine), the goal was to foster collective immunity so that risk populations could also be protected. This, however, entailed a rather unusual issue: how to persuade parents whose children already received an IPV to revaccinate their children, now with a live yet attenuated version of the virus that was excluded from the national vaccination program in 2004. The challenge therefore was a call for social solidarity -asking parents to vaccinate their children mainly for the sake of protecting unknown at risk populations and to take part in the larger global goals of the polio eradication program. This challenge stands at the core of our investigation. We see the OPV campaign of summer 2013 as a good case study of the tension between individualism and social solidarity in seeking the cooperation of the public. Methods: We draw on a qualitative study that included participant observation, document reviews and interviews with policy-makers, parents, journalists, public health experts and community leaders. These data were analyzed in order to unravel the ways in which self-interest, community and solidarity were conceived by different agents during the vaccination campaign.

Vaccination uptake and income inequalities within a mass vaccination campaign

“…Compliance with or opposition to vaccination falls within the limits of state power in the private sphere (like family, religion, and health beliefs) that is often emphasized by ethnic tensions [24]. Thus, Israel’s 2013 polio vaccination campaign is intricately linked to, and must be understood in the context of communities’ social standing [24].…”

“…Compliance with or opposition to vaccination falls within the limits of state power in the private sphere (like family, religion, and health beliefs) that is often emphasized by ethnic tensions [24]. Thus, Israel’s 2013 polio vaccination campaign is intricately linked to, and must be understood in the context of communities’ social standing [24]. Understanding the decision to vaccinate in larger social contexts, in contrast to viewing vaccination as an individualized decision alone, is not unique to Israel [24].…”

“…Thus, Israel’s 2013 polio vaccination campaign is intricately linked to, and must be understood in the context of communities’ social standing [24]. Understanding the decision to vaccinate in larger social contexts, in contrast to viewing vaccination as an individualized decision alone, is not unique to Israel [24]. Policymakers are encouraged to strengthen principles of solidarity in their efforts to eradicate SES and equality disparities in healthcare (https://www.cambridge.org/core/books/solidarity-in-biomedicine-and-beyond/067DC974D204F6EDE679816213433456).…”

The cycle of distrust in health policy and behavior: Lessons learned from the Negev Bedouin

“…NZDs are caused by a combination of environmental factors such as urbanization, which enables pathogen-vector-host interactions [29,30]; economic factors, such as global trade, which enables disease dissemination [31]; and political factors, such as social inequalities, which affect vulnerable populations most heavily [32]. This array of factors, recently described as "structural drivers of vulnerability to zoonotic diseases," [33] drives distrusting action-reaction (and also "inaction," as later explained) in policy and behaviors, hinders reporting of livestock disease [34], fuels vaccination opposition, and hampers bio-security [35,36].…”

Individualism and social solidarity in vaccination policy: some further considerations

“…The paper by Boas and colleagues [1] provides an interestingly broad perspective on an important public health issue, that of vaccine uptake, and value was added by the breadth of disciplines among the authors. The description of the challenges encountered in striving to achieve a reasonable level of vaccine uptake in a situation of increasing risk were well set out and this reader found the analogy with the military a particularly fascinating and thought-provoking strand.…”