Pre-empting concerns about child vaccination: How nurses anticipatorily address parental concerns about “New” vaccines

Abstract

As childhood vaccination rates are declining, healthcare professionals’ conversations with parents are increasingly important for navigating a diverse set of concerns about vaccination. This article uses Conversation Analysis to illustrate that and how Dutch nurses pre-empt parental concerns that could be the basis for vaccination refusal during home visits to parents of newborn babies. We analysed 41 conversations recorded in the Netherlands between February and December 2024 in which the then recently introduced rotavirus vaccine is discussed. We identified three resources which nurses use to pre-empt concerns regarding the novelty and administration mode of the rotavirus vaccine: (1) self-initiated self-repairs, (2) contrast formulations and (3) accounts. By pre-empting parental concerns, nurses anticipatorily rule out possible (mis)interpretations of what they said and steer parents towards more apposite interpretations. Crucially, pre-emption work occurs before parental concerns have been explicitly voiced and at the beginning of the presentation of the vaccine by the nurse. Our findings suggest two key tensions within this pre-emption work: (1) a progressivity paradox – where pre-empting slows down progressivity locally while promoting overall progressivity and (2) a concern paradox – in which by anticipatorily addressing parental concerns, nurses may inadvertently suppress their articulation by parents.