Vaccine Refusal and Pharmaceutical Acquiescence: Parental Control and Ambivalence in Managing Children’s Health

Abstract

Parents who confidently reject vaccines and other forms of medical intervention often seek out pediatric care, medical treatments, and prescription medications for their children in ways that seem to contradict these views. Drawing on in-depth interviews with 34 parents who rejected some or all vaccines for their children, this article examines the strategies they use to pharmaceutically manage their children’s health, even when espousing a larger rejection of pharmaceutical interventions like childhood vaccines. Rather than treating decision-making as solely an internal process, this article shows how medication use results from individual, interactional, and institutional contexts, with different mechanisms of encouragement and enforcement. Using three illustrative cases, I show how parents manage ambivalence, which allows them to accept medication for their children as a tool to be deployed as deemed necessary in particular contexts while at the same time communicating their rejection of it. I conclude with suggestions for how to engage parents around healthcare decision-making.

Parental Attitudes and Perceptions Towards Vaccines

“…A centrally funded public education program could help inform parents prior to launching a new vaccine in the routine immunization program. However, a recent review states that a deeper understanding of the priorities, processes, and ambivalences could be instructive to providers who work with families and those who seek to improve public health participation, particularly around vaccines [19].…”

Opting Out: Individualism and Vaccine Refusal in Pockets of Socioeconomic Homogeneity

“…Identifying this strand of individualism as the root of vaccine refusal is important but it cannot, on its own, explain why vaccine exemptions are especially high in certain settings. Parents personalize choices about medical interventions based on unique features of their childrearing context (Reich 2020), which suggests opt-out individualism could manifest in specific geographic and spatial contexts. We argue that pockets of socioeconomic homogeneity amid diversity could both attract parents with this opt-out orientation and reinforce that mindset.…”

“…We argued that the spatial distribution of PBEs could be tied to broader, and largely inexorable, social forces associated with rising expectations for personalized consumption among middle-and upper-middle-class families (Reich 2016(Reich , 2020. Although critics have identified the negative consequences of the school choice movement (Buckley and Schneider 2009;Lubienski 2003), housing developments tailored to cultural tastes and political views (Bishop 2008), and personalized medicine (Dickenson 2013), these trends are largely beyond the control of the agencies charged with protecting community health.…”

Hopes, hesitancy and the risky business of vaccine development

“…Decision-making about whether or not an individual or their child should be vaccinated is a rich, nuanced and contextual phenomenon (Reich, 2020) reflecting a number of factors. This includes interactions with family and friends -with Brunson (2013) and Attwell et al (2018) showing that social networks shape and reinforce beliefs and subsequent vaccination behaviour.…”

“…This includes criticising vaccinating parents for not possessing the confidence in vaccination to realise that the unvaccinated do not pose risks to their children. Vaccines are a preventative public health strategy that label everyone at risk of disease rather than as 'healthy' or 'ill' (Armstrong, 1995) but may nevertheless primarily be understood as a tool for individual benefit (Reich, 2020). Overall, this scholarship suggests a powerful disconnect between the population-level logic underpinning vaccination and a general public concerned with choice and the empowerment of the individual operating within a market economy (Blume, 2006, p.639;Hobson-West, 2003;Hobson-West, 2007;Reich, 2018, pp.…”