I’m a medical anthropologist, and I have studied vaccine selectivity – that is, when parents choose to give their children only a select subset of required vaccinations, most often skipping chicken pox and hepatitis B immunizations. I’ve also looked at cases of complete refusal. If we want to encourage vaccinations, we must listen to what selective parents have to say. We must also consider why they say it.
My findings support the growing body of research showing that the more we force people to take sides, the harder it is to discuss vaccination, let alone to build common cause and work together for the public good. Authoritarian acts such as just flinging facts at people or mandating vaccinations can cause vaccine-selective parents to dig their heels in further. What we need instead is civil discourse.
My findings confirm that the more embedded we are within a given community and the more we identify with that group, the less likely we are to disagree with their norms. Why? That’s easy: We can’t risk the loss of friends and relations.
Even full vaccinators conform for social purposes. In my research, most parents who gave any reason for choosing to vaccinate beyond “doctor’s orders” said they were following their parents’ and society’s lead: “it’s a cultural norm,” one mom told me. Very little vaccine-specific self-education was undertaken by fully-vaccinating parents, who knew less about immunization than selective vaccinators (those who choose some vaccinations but not others). Full vaccinators gave notably fewer correct answers regarding herd immunity, for instance.
It’s important to note that a third subset of participants, the total refusers, knew the least, though there were very few of them. Despite that fact, in the public’s imagination all who do not fully vaccinate are stereotyped as extremists and caricatured as tin-foil hat-types. That’s a big problem. Name-calling is one of the things that got us into this mess, making vaccination so hard to talk about. Often, it even pushes people to double down on their skepticism.
Instead, we should work to create conditions under which people holding differing positions can talk to each other. This leads to more open, respectful, bridge-building discussions of vaccination among parents charged with making immunization decisions. We need this kind of dialogue if we are to enable a more productive flow of information. As sociologist Jaron Harambam has noted, a democratic approach to science is much more likely to result in “truth” than one that relies only on the institutionally narrowed ideas of “experts.”
Elisa (EJ) Sobo is professor and chair of the Department of Anthropology at San Diego State University. Past president of the Society for Medical Anthropology), she has published numerous peer-reviewed journal articles and books, including a forthcoming second edition of “Dynamics of Human Biocultural Diversity: A Unified Approach” (2019).