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Risk and trust in vaccine decision making.

By R. E. Casiday

Abstract

Vaccines are widely hailed as vital, safe, and cost-effective public health interventions that save lives and protect health. However, from the development of the first smallpox vaccine at the end of the eighteenth century until the present day, the legitimacy and safety of vaccination has frequently been challenged. Individuals making choices about vaccination have to evaluate reports, often contradictory, about risk. The ways that parents evaluate these reports and make decisions are crucially informed by trust. This paper examines and compares public evaluations of risk and the role of trust in three historic vaccine controversies: the implementation of the global smallpox eradication campaign, the debate over the whooping cough vaccine in the 1970s and 1980s in Great Britain, and the current debate over the MMR vaccine in Britain. The discussion of the MMR controversy will draw upon my recent fieldwork interviewing parents about the vaccination decisions they have made for their children. Parents balance a number of potential risks against one another and choose which risks they are most concerned about. In addition, the importance of herd immunity to successful immunisation programmes allows for an investigation of how individual and collective risks and benefits relate to one another. These issues are only recently beginning to be incorporated into the literature on risk, trust and sociocultural theory

Publisher: Department of Anthropology, Durham University
Year: 2005
OAI identifier: oai:dro.dur.ac.uk.OAI2:6898
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