title: Vaccine Rejecting Parents' Engagement With Expert Systems That Inform Vaccination Programs.
abstract: 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.
authors.affiliation: Sir Walter Murdoch School of Public Policy and International Affairs, Murdoch University, South Street, Murdoch, WA, 6150, Australia. k.attwell@murdoch.edu.au.|Immunisation Alliance of Western Australia, Cockburn Integrated Health and Community Facility, Suite 14, 11 Wentworth Parade, Success, WA, 6164, Australia. k.attwell@murdoch.edu.au.
authors.forename: Katie
authors.initials: K
authors.lastname: Attwell
authors.affiliation: School of Public Health, Faculty of Medicine, Faculty of Nursing, University of Sydney, Sydney, NSW, 2006, Australia.
authors.forename: Julie
authors.initials: J
authors.lastname: Leask
authors.affiliation: University of Waterloo, 200 University Ave West, Waterloo, Ontario, N2L3G1, Canada.
authors.forename: Samantha B
authors.initials: SB
authors.lastname: Meyer
authors.affiliation: Faculty of Medicine, Nursing and Health Sciences, Flinders University, Adelaide, SA, 5001, Australia.
authors.forename: Philippa
authors.initials: P
authors.lastname: Rokkas
authors.affiliation: Department of Public Health, Flinders University, Adelaide, SA, 5001, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Ward
mesh_terms: D000328:Adult; D001294:Attitude to Health; D001315:Australia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004345:Drug Industry / Q000941:ethics*; D005103:Expert Systems; D005260:Female; D019538:Health Care Surveys; D006266:Health Education / Q000941:ethics*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017589:Immunization Programs / Q000941:ethics*; D007223:Infant; D033181:Information Dissemination / Q000941:ethics; D007407:Interviews as Topic; D008297:Male; D010290:Parents / Q000193:education / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D035502:Trust; D014611:Vaccination / Q000523:psychology* / Q000706:statistics & numerical data; D014612:Vaccines / Q000008:administration & dosage*
chemical_list: D014612:Vaccines
keywords: Giddens; Modernity; Qualitative; Trust; Vaccination; Vaccine hesitancy