Anti-vaccination Movements and Their Interpretations

According to the paper, over the last two or three decades, growing numbers of parents in the industrialised world are choosing not to have their children vaccinated. In trying to explain why this is occurring, public health commentators refer to the activities of an anti-vaccination 'movement'. In this paper, the author explores this idea of an
anti-vaccination 'movement' and questions to what extent such a movement can be said to have contributed to declining vaccination rates. He states that from a public

health perspective focusing attention on organised opponents of vaccination is appealing because it "unites health professionals behind a banner of reason. At the same

time it diverts attention from a potentially disruptive critique of vaccination practices; the critique in fact articulated by many parents." This paper argues that identifying

anti-vaccination groups with other social movements may ultimately have the opposite effect to that intended.

The paper begins by sharing how historically there have been widespread instances of resistance to compulsory vaccination. Today the view is frequently expressed that

antivaccination movements are re-emerging based on concerns about vaccine safety. The author goes on to discuss social movements in general, providing the

definition that "Social movements are distinguished from other collective actors, such as political parties and pressure groups, in that they have mass mobilisation, or
the threat of mobilisation, as their principal source of social sanction, and hence of power". "New" social movements are being defined as those that have

unconventional ways of expressing popular protest, or that focus on sought changes in civil society rather than in politics or the political process.

The paper reviews experiences drawn from the United Kingdom and the Netherlands. In the early 1970s evidence that vaccination against pertussis (whooping cough) was sometimes associated with highly unpleasant side effects was accumulating. In most cases these side effects, though alarming to parents, were local, not serious, and disappeared quite quickly. More worrying, however, were new reports linking the vaccine with possibly permanent brain damage in a small number of cases. Gordon Stewart, from Glasgow University, was one who did much to attract attention to the possible risks of this vaccine: going so far as to suggest that its risks outweighed its benefits (Stewart, 1977). In Britain public confidence in pertussis vaccine fell dramatically, and vaccination coverage dropped from 70–80% to around 40%. In the Netherlands by contrast, although Stewart’s conclusions regarding possibly serious side effects of the pertussis vaccine were known in public health circles no corresponding decline in public confidence occurred. Recently the suggestion has been made that Britain ‘‘played a central role in defining, promoting, and ultimately exporting this dispute."

How to understand the difference between these two countries in response to the suggestion of possible risk? Was what occurred in Britain an expression of some
underlying discontent with the way vaccination was administered, so that the new worries were - for some - the straw that broke the camel’s back? Whilst vaccination
is (and was then) both free and voluntary in both countries there are some differences in its organisation. In the Netherlands most children are vaccinated at an
Infant Welfare Centre (Consultatiebureau) whereas in Britain the general practitioner plays a larger role. Dutch experts do commonly attribute the country’s very high immunisation
rate (averaging around 95%) to the effective organisation of vaccination services, and an efficient surveillance system. Still more important is the fact that controversy

extended far beyond the medical profession. The Guardian newspaper, for example, covered the controversy at length, with numerous reports of parents claiming compensation for what they believed the damage caused by the whooping cough vaccine.

According to the paper, a few studies by social scientists focus on the experiences, behaviour and concerns of individual parents. A Dutch study took a sample of 350 families with at least one child aged 0–4 and 150 families with at least once child aged between 9 and 10. A few respondents weren't wholly sure of the vaccination status of their child/ children, so that somewhere between 81% and 88% of the children were known to be wholly vaccinated. The survey showed that 75% of the respondents had had at least one discussion regarding the desirability of vaccination, typically with a physician or nurse from the home care service or the family doctor: the vast majority were satisfied with the way they’d been informed. Most (85%) had consulted published sources - mostly materials provided by the child health services. Only 2% of these parents had looked to the internet for guidance. Only 16% felt a need of more information: these were largely the younger and better educated mothers. The issues on which more information was felt necessary were side effects; duration of protection; the risks of not vaccinating. All in all the picture that emerges from this study is of a society that generally feels itself sufficiently well informed and that above all is willing to trust.

Another study conducted in the Netherlands found indications that widespread trust in the vaccination programme may now be eroding. Various studies suggest that negative views of childhood vaccination are common among practitioners of some forms of alternative medicine and that unwillingness to vaccinate is particularly common among their patients (at least in Europe). The group of parents holding ‘‘alternative’’ views of health and medicine, for example, homeopathic or anthroposophic, is so small in number that their non-compliance has little or no effect on the overall vaccination rate but because views such as these seem to be finding increasing sympathy among the population at large, better understanding of their perceptions of risk seem valuable. The author points out that some have argued that restoring public faith in vaccines and vaccination is a vital but essentially political challenge. Good information is crucial, but not sufficient, and a concerted advocacy campaign is needed.

According to the author, anti-vaccinationism has not yet found its (social) theorists. Nevertheless its appeal to individual rights, including the right to contest official assessments of vaccine safety, could easily become a new and powerful strand in this more far-reaching political transformation. In other words, in so far as antivaccination organisations come to identify with the social movements as a collective attempt at building an ‘‘oppositional culture’’ (or empowering the ‘‘radical democratic citizen’’), dialogue will be ineffective. In that way, to speak of them as a ‘social movement’, as many in the world of public health now do, precisely by stimulating theoretical reflection on their claims, may have the opposite effect to that intended.