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How service deliverers experience and manage risk

Health professionals and the vaccine narrative: ‘the power of the personal story’ and the management of medical uncertainty

Pages 114-136 | Received 16 Sep 2015, Accepted 12 May 2016, Published online: 03 Jun 2016
 

Abstract

Some vaccine supporters interpret vaccine uncertainties as a form of public ignorance caused by patients’ online research, failed physician–patient relationships, or inadequate knowledge translation. These interpretations often portray health professionals as homogeneously accepting of all scheduled vaccines for all patients. Nonetheless, health professionals may have limited knowledge about vaccines because the demands of their profession require them to have a broad understanding of a variety of health topics. In this article, I draw on data from interviews with twenty-six physicians and seven nurses in Alberta, Canada between 2013 and 2014, to examine how they used narratives to convey confidence, uncertainty, or doubts in vaccines. All interviewees supported the culturally dominant vaccine narrative that vaccines are essential to population health, yet they also spoke about uncertainties. Interviewees managed their uncertainties through tactics that confirmed accepting vaccination was the most desirable course of action. With each of these tactics, interviewees shared narratives about communicable diseases, vaccine benefits and risks to individual patients, and their reasons for trusting in medical science. When these narratives did not fully resolve medical uncertainties, health professionals often explained that either vaccination was beyond their professional responsibilities or that their uncertainties were irrelevant.

Acknowledgements

Thanks are extended to Dr. Stephen A. Kent, who supervised this project and offered initial comments on the manuscript. I also appreciate the guidance I received from my candidacy committee members Dr. Tim Caulfield, Dr. Amy Kaler, Dr. Robyn Braun, and Dr. Laurel Strain. Finally, I extend gratitude to Dr. Patrick McLane for reading and commenting on a draft of this article.

While undertaking the research on which this article is based I received the following funding: Izaak Walton Killam Memorial Trust (Izaak Walton Killam Memorial Scholarship), the Social Sciences and Humanities Research Council of Canada (Joseph-Armand Bombardier Canada Graduate Scholarships), the University of Alberta (President’s Doctoral Prize of Distinction and the Dissertation Fellowship), and the Department of Sociology research grant.

Disclosure statement

No potential conflict of interest was reported by the author.

Additional information

Funding

This work was supported by Izaak Walton Killam Memorial Trust (Izaak Walton Killam Memorial Scholarship), the Social Sciences and Humanities Research Council of Canada (Joseph-Armand Bombardier Canada Graduate Scholarships), the University of Alberta (President’s Doctoral Prize of Distinction and the Dissertation Fellowship), and the Department of Sociology research grant.

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