Vaccine Hesitancy

Last year (2014), the rate of measles infections reached a 16-year high in Australia, mainly due to travellers catching measles overseas and passing it on to unvaccinated children after coming home. We are in serious danger of horrible diseases which had been eliminated from Australia, making a comeback due to a rapid increase in parents failing to have their children vaccinated. The conventional term, ‘vaccine hesitancy’ (VH), implies hesitancy in relation to vaccination, but some people are not hesitant at all but decisive in refusing vaccination, and some are hesitant about a specific vaccine not vaccination in general. However, the term is accepted as indicating this entire field of activity. Since the Christian Scientists confirmed that they do not have a conscientious objection to vaccination, there is now no basis for objection on religious grounds. The tolerance and legal protection extended to religious orders is firmly established in the principles of secular government. Implicit in this tolerance is the reciprocal obligation on religious orders to conform to the law of the land. Conflicts which have arisen between religious and secular law have been resolved historically by negotiation, and continued tolerance relies on past compromises. Examples include the allowance for religious holidays celebrated by minority communities, and the right of conscientious objection to performing abortion or serving in the army. In the absence of such formal accommodation, the secular law prevails, forbidding genital mutilation and so-called honour killing, for example. Nowhere in this practice is there room for an individual or group to unilaterally declare a conscientious objection on the basis of personal conviction. Such an idea would make a mockery of the very idea of human civilisation. There remain however a range of reasons behind failure to access available vaccination programs, and different responses by the community are required in each case. The Abbott government’s policy to send a ‘price signal’ by withdrawing welfare payments will work for a minority of those who have not had their children vaccinated but will alienate and harden the resistance of an expanding section of refusers for whom a legal penalty would only confirm their scepticism. Socio-economic status and level of education have proved to be poor predictors of vaccine hesitancy and the usual empirical-demographic and public education approaches to public health challenges have proved ineffective. Policy makers do not know what to do to improve the uptake of vaccination. Peretti-Watel et al (2015) use the ideas of ‘reflexive modernity’, ‘risk society’ and ‘life politics’ from Ulrich Beck and Anthony Giddens to describe the field of vaccine hesitancy in terms of two dimensions, parallel to the way that Giddens described ‘beyond left and right’ in the political domain, with his ‘political compass’. That is, just as political opinion can longer be mapped on to a single axis, people cannot be seen as simply more or less reluctant to vaccinate. The horizontal axis measures the extent to which the subject has embraced the modern trends of risk culture in which the world is full of unpredictable sources of danger, and ‘healthism’ in which the subject is someone who takes active responsibility for managing their own health. The vertical axis measures the subject’s disposition to trust the entire system of expert culture and established power and authority, or not.