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Abstract
Despite the existence of an effective pharmaceutical means for its prevention available now for about 70 years, influenza remains an important contributor to morbidity and mortality figures due to respiratory infectious diseases through the world. Understanding why people accept or reject being vaccinated in our societies may contribute to improve substantially public health interventions in this domain by addressing the main reasons that lead individuals and groups to neglect immunization. Research into the cognitive and social causes of influenza vaccination patterns has developed over the last decades. However, it has yielded mostly inconsistent or contradictory results. To make sense of the body of data available and to improve future research, the authors argue for the adoption of a comprehensive sociocultural understanding of vaccination behavior. This could be constructed from existing social stratification models used in social sciences and should take into account how culture determines cognition.
Financial & competing interests disclosure
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
No writing assistance was utilized in the production of this manuscript.
Key issues
Current studies of the social and psychological pathways to influenza immunization have yielded inconsistent or contradictory results thereby failing in providing a comprehensive body of knowledge on the subject.
Most studies are unclear on the individual-level mechanism through which social factors affect immunization behavior and on how immunization-related beliefs are formed.
Most explanations for immunization behaviors are based on the idea of availability of information or vaccines, which fails to make sense of a great portion of these behaviors.
Availability becomes an issue once people are already convinced of the utility of being vaccinated. What is at stake is how people become convinced of this fact.
Studying persuasion means understanding how people select the information they are confronted to.
Social studies of health culture have provided strong support for the claim that selection of information is culturally biased.
Mary Douglas’ cultural theory of risk provides a strong basis for a comprehensive and predictive model of vaccination behavior.
Contemporary scholars following this path have highlighted ways in which communication strategies can be improved to increase recourse to influenza immunization.