Why do parents who usually vaccinate their children hesitate or refuse? General good vs. individual risk

Abstract

This study examines vaccination hesitancy or refusal following the 2013 polio outbreak in Israel, based on two theoretical models. The first is Sandman’s theoretical model, which holds that risk perception is comprised of hazard plus outrage. The second model is the affect heuristic that explains the risk/benefit confounding. It aims to expose the barriers that inhibited parental compliance with OPV vaccination for their children. The study employed mixed methods – a questionnaire survey (n = 197) and content analysis of parents’ discussions in blogs, Internet sites, and Facebook pages (n = 2499). The findings indicate that some parents who normally give their children routine vaccinations decided not to give them OPV due to lack of faith in the health system, concerns about vaccine safety and reasons specific to the polio outbreak in Israel. Some vaccinated due to a misunderstanding, namely, they believed that OPV was supposed to protect their children, when it was actually for overall societal well-being. This study highlights the difficulty of framing the subject of vaccinations as a preventive measure, especially when the prevention is for society at large and not to protect the children themselves. The findings of this study are important because they provide a glimpse into a situation that can recur in different places in the world where a disease considered to have been ‘eradicated’ returns, and the public is required to take measures which protect the public but which might put individuals at risk. The conclusions from the analysis of the findings of this study are that the public’s risk perception is based on a context-dependent analysis, which the communicating body must understand and respect.

Keywords:

• polio outbreak in Israel
• OPV vaccination
• vaccination hesitancy or refusal
• risk perception and communication
• context-dependent analysis
• hazard plus outrage
• affect heuristic

Notes

1. ‘Herd immunity’ describes a form of immunity that occurs when the vaccination of a significant portion of a population provides a measure of protection for individuals who have not developed immunity (John and Samuel 2000).

2. Websites were defined as pro/anti-vaccination following text analysis which indicated that articles published on those sites consistently supported/opposed vaccination.