TY - JOUR
T1 - “Do-it-yourself”
T2 - Vaccine rejection and complementary and alternative medicine (CAM)
AU - Attwell, Katie
AU - Ward, Paul R.
AU - Meyer, Samantha B.
AU - Rokkas, Philippa J.
AU - Leask, Julie
N1 - Funding Information:
Expert advice was sought from Jon Wardle, author of the review discussed here. The Fremantle data was gathered by Katie Attwell while working for the Immunisation Alliance of Western Australia, a not-for-profit immunisation advocacy organisation. The Alliance received funding from Sanofi Pasteur in the form of a $20,000 unrestricted grant to develop and evaluate the I Immunise campaign, which itself was funded by the Department of Health , Western Australia and is described in a separate paper ( Attwell and Freeman, 2015 ). Neither external organisation contributed to the study design; data collection, analysis, interpretation or writing, nor did they influence manuscript submission decisions. Jane Jones and Michael Wise from IAWA were particularly crucial to the research process and Sarah Lee Parker transcribed the WA interviews. The data collection in South Australia was funded by the Flinders Medical Centre Foundation as a Seeding Grant, with no input into the decisions and processes outlined above. Julie Leask receives funding from the Australian Government Department of Health and the National Centre for Immunisation Research and Surveillance for research in addressing vaccine hesitancy. The authors thank the anonymous reviewers for their constructive feedback on earlier versions of this manuscript.
Publisher Copyright:
© 2017 Elsevier Ltd
PY - 2018/1
Y1 - 2018/1
N2 - In this article, we elucidate a symbiotic relationship between complementary and alternative medicine (CAM) and rejection of, or hesitancy towards, vaccination. In Fremantle, Western Australia, and Adelaide, South Australia, we conducted in-depth interviews from September 2013–December 2015 with 29 parents who had refused or delayed some or all of their children's vaccines. Our qualitative analysis found that for many, their do-it-yourself ethic and personal agency was enhanced by self-directed CAM use, alongside (sometimes informal) CAM practitioner instruction. Reifying ‘the natural,’ these parents eschewed vaccines as toxic and adulterating, and embraced CAM as a protective strategy for immune systems before, during and after illness. Users saw CAM as harm-free, and when it came to experiences that non-users might interpret as demonstrating CAM's ineffectiveness, they rationalised to the contrary. They also generally glossed over its profit motive. CAM emerged as part of an expert system countering Western medicine. CAM's faces were trusted and familiar, and its cottage capitalism appeared largely free from the taint of “Big Pharma.” A few parents employed a scientific critique of CAM modalities – and a minority were dubious of its profit motive – but others rejected the epistemology underpinning biomedicine, framing CAM as a knowledge not poisoned by avarice; a wisdom whose very evidence-base (anecdote and history) was demeaned by an arrogant scientific process only permitting belief in that which could be quantified. However, all parents engaged with Western medicine for broken bones and, sometimes, medical diagnoses. Our analysis suggests that pro-vaccination health professionals, policymakers and information-providers seeking to address the role of CAM in vaccine rejection face significant challenges due to the epistemic basis of some parents' decisions. However, we make some suggestions for professional practice and policy to enhance trust in vaccination.
AB - In this article, we elucidate a symbiotic relationship between complementary and alternative medicine (CAM) and rejection of, or hesitancy towards, vaccination. In Fremantle, Western Australia, and Adelaide, South Australia, we conducted in-depth interviews from September 2013–December 2015 with 29 parents who had refused or delayed some or all of their children's vaccines. Our qualitative analysis found that for many, their do-it-yourself ethic and personal agency was enhanced by self-directed CAM use, alongside (sometimes informal) CAM practitioner instruction. Reifying ‘the natural,’ these parents eschewed vaccines as toxic and adulterating, and embraced CAM as a protective strategy for immune systems before, during and after illness. Users saw CAM as harm-free, and when it came to experiences that non-users might interpret as demonstrating CAM's ineffectiveness, they rationalised to the contrary. They also generally glossed over its profit motive. CAM emerged as part of an expert system countering Western medicine. CAM's faces were trusted and familiar, and its cottage capitalism appeared largely free from the taint of “Big Pharma.” A few parents employed a scientific critique of CAM modalities – and a minority were dubious of its profit motive – but others rejected the epistemology underpinning biomedicine, framing CAM as a knowledge not poisoned by avarice; a wisdom whose very evidence-base (anecdote and history) was demeaned by an arrogant scientific process only permitting belief in that which could be quantified. However, all parents engaged with Western medicine for broken bones and, sometimes, medical diagnoses. Our analysis suggests that pro-vaccination health professionals, policymakers and information-providers seeking to address the role of CAM in vaccine rejection face significant challenges due to the epistemic basis of some parents' decisions. However, we make some suggestions for professional practice and policy to enhance trust in vaccination.
KW - Complementary and alternative medicine
KW - Epistemology
KW - Immunisation
KW - Vaccination
KW - Vaccine hesitancy
UR - http://www.scopus.com/inward/record.url?scp=85034733070&partnerID=8YFLogxK
U2 - 10.1016/j.socscimed.2017.11.022
DO - 10.1016/j.socscimed.2017.11.022
M3 - Article
C2 - 29175699
AN - SCOPUS:85034733070
VL - 196
SP - 106
EP - 114
JO - Social Science and Medicine
JF - Social Science and Medicine
SN - 0277-9536
ER -