title: Reframing medicine's publics: the local as a public of vaccine refusal.
abstract: Although medical and public health practitioners aim for high rates of vaccination, parent vaccination concerns confound doctors and complicate doctor-patient interactions. Medical and public health researchers have studied and attempted to counter antivaccination sentiments, but recommended approaches to dispel vaccination concerns have failed to produce long-lasting effects. We use observations made during a small study in a rural area in a southeastern state to demonstrate how a shift away from analyzing vaccination skepticism as a national issue with a global remedy reveals the nuances in vaccination sentiments based on locality. Instead of seeing antivaccinationists as a distinct public based on statistical commonalities, we argue that examining vaccination beliefs and practices at the local level offers a fuller picture of the contextualized nature of vaccination decisions within the psychosocial spaces of families. A view of vaccination that emphasizes the local public, rather than a globally conceived antivaccination public, enables medical humanists and rhetoricians to offer important considerations for improving communications about vaccinations in clinical settings.
authors.affiliation: George Mason University, Fairfax, VA, USA, hlawren2@gmu.edu.
authors.forename: Heidi Y
authors.initials: HY
authors.lastname: Lawrence
authors.forename: Bernice L
authors.initials: BL
authors.lastname: Hausman
authors.forename: Clare J
authors.initials: CJ
authors.lastname: Dannenberg
mesh_terms: D002648:Child; D002675:Child, Preschool; D003142:Communication; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006809:Humanities; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D007252:Influenza Vaccines / Q000008:administration & dosage; D007251:Influenza, Human / Q000517:prevention & control / Q000523:psychology; D007406:Interview, Psychological; D008297:Male; D033282:Parental Consent / Q000523:psychology; D011634:Public Health; D012424:Rural Population; D016312:Treatment Refusal / Q000523:psychology*; D014611:Vaccination / Q000523:psychology*; D014768:Virginia
chemical_list: D007252:Influenza Vaccines