Understanding vaccination refusal: a qualitative study of parents' health beliefs and practices
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Date
2009Author
Tombs-Heirman, Eva
Metadata
Abstract
Vaccinations and immunisations have become one of the cornerstones of health promotion
and preventive health care globally and they are firmly embedded within the bio-medical
model of medicine. That there have been objectors to mass vaccination programmes from
the very beginnings of its history is often forgotten. Objectors are often characterised as
dissenters, as irresponsible and implicated in the failure of public health policy to prevent
epidemics by interfering with herd immunity protection of the population. This thesis aims
to explore the reasons why some people actively choose not to vaccinate their children and to
examine their health beliefs and practices.
Existing work with non-vaccinating parents has been dominated by quantitative and
epidemiological studies attempting to determine why parents do not vaccinate or mixed
method studies which also focus on lay perspectives; they aim to identify issues in order to
help programmes to increase vaccination uptake. There is a shortage of studies focusing on
the health beliefs of parents who make active decisions not to vaccinate in the context of
those beliefs and health related practices.
This study focuses on a small group of parents who have consciously decided not to have
their children vaccinated for the common childhood illnesses and extends to those parents
where travel vaccinations were also refused. Fifteen adults were studied, one was not a
parent; in depth open ended interviews were conducted. The research process highlights
both the level of trust between researcher and respondent and the experience of feeling
marginalised and misunderstood for their beliefs. Both influence the data generated.
The findings indicate that parents’ experience with healthcare practitioners varied
enormously; from support and encouragement for their stance on vaccination to accusations
of being a ‘bad parent’. In this study the respondents chose not to partake of the vaccination
regime for their children because they believed that the vaccinations were either an
unnecessary intervention, or, might do more harm than good. Some parents would never
have any vaccination for themselves or their children in any circumstances as they did not
agree with the principle at the outset. Others did not rule out all vaccinations in all
circumstances, but kept an open mind. How people came to their points of view, who and
what influenced them in their health beliefs and decision making varied and was
complicated. Influences included the media, books, individual alternative health-care
practitioners, parents, friends, the world wide web or some kind of ‘gut feeling’ that the
practice was ‘wrong’, or a combination of some or all of these. There was no evidence for
anti-vaccination pressure from any one organisation or person. Lack of faith, trust or belief
in science as a health promoting body of knowledge was a significant aspect for some of the
parents. Mistrust in the ethics of the pharmaceutical companies and their relationships with
both the government and general practitioners made some of the parents mistrust their
advice. Those parents who had a scientific background disagreed with the science of
vaccinations.
The conclusion highlights the difficult position people who do not believe in vaccination find
themselves in and the role of health beliefs that are embedded in different understandings of
what constitutes health-illness and how health can be maintained.