no. 08_september 2020
Public debates about the pros and cons of vaccination are highly emotionally charged and polarised. This is also the case in the context of contemporary controversies about proper responses to the COVID-19 pandemic. Fears of a potential compulsory vaccination against the virus express themselves, among others, in public protests and demonstrations all around the world as well as the widespread dissemination of conspiracy theories concerning the alleged malign agenda of pharmaceutical companies, states or NGOs.
In my essay I will trace the connections between vaccination and education using examples of German history from the 19th and 20th centuries. Germany did not take a special path (Sonderweg), as one might have assumed given its historical development and the five different political systems. Rather, it is a typical example of the European political approach to vaccination. These form the background for my initial questions: what was the relationship between social order and vaccination programmes and what role did schools and educational models play in vaccination programmes? It is demonstrated that schools played a major role in both in the enforcement of compulsory vaccination and the establishment of vaccination education.
The vaccination of children has unique ethical implications. This article examines the ethics of childhood vaccination from two different perspectives. First, vaccination is approached as a preventive medical decision involving a child, using the ethical framework of medical decision-making for children. Second, vaccination is considered from a social and societal perspective, drawing on arguments from justice. From both these perspectives it is apparent that an ethical obligation exists to protect children against vaccine-preventable diseases by the appropriate use of vaccination. These ethical considerations have implications for policy, and in the paper a three-tiered approach to vaccination policy is defended: judicious use of mandatory policies, educational interventions, and building of trust.
An analysis of ‘misinformation’, a primary framing for vaccination dissent, illuminates weaknesses in understanding vaccination controversy and the dissemination of false beliefs. Rather than approaching vaccine dissenters as misinformed, we can identify how untruths circulate in good-faith efforts to identify facts and clarify the challenges that the Internet poses to elites’ control of information. When we shift our view, we can see how narrow social networks and lack of empathy for others drives polarized perceptions of “fake news” and threatening cultural trends. The antidote to these problems is education in empathy, enhanced identification with others different from ourselves. Examples from the Covid-19 pandemic and Black Lives Matter protests in the U.S. provide illuminating perspectives about how the humanities can be harnessed to solve persistent social problems.
Proponents of vaccination would like to educate parents with the aim of getting them to agree with the dominant view. This creates a tension with an alternative goal of education, to encourage people to think for themselves. The challenge of learning about vaccination is increased by the public debate in which proponents and critics diverge dramatically and do not engage with each other’s arguments.
While from a medical point of view it seems obvious that “vaccination is one of the most effective ways to prevent disease” (WHO, 2020), some people reject vaccinations for various reasons. The scientific discourse refers to them as vaccination hesitant. In this article we take a closer look at the different concepts of knowledge underlying vaccination hesitancy. We look at the history of vaccination hesitancy, examine current studies and report on select, empirical research into parental vaccination hesitancy, that we carried out in 2014/2015. Finally, we argue that the key challenge in vaccination education is not only to provide information but to build confidence.
Infectious agents, which can spread rapidly within large groups of people, have always been a threat to human health. Hygiene and vaccination measures have played a crucial role in reducing diseases on a large scale. Globally, however, infectious diseases continue to affect the differences in life expectancy between the populations of different countries. In societies with a high standard of living and well-trained health care systems, the threat posed by infectious diseases has been comprehensively suppressed through successes in prevention. This can lead to individuals deciding against immunization because they do not perceive an individual threat from the disease. Global pandemics such as HIV and currently SARS-CoV-2, make it clear however, that many infectious diseases cannot be regulated without the presence of vaccines, or can only be regulated by accepting considerable consequences for society. A single vaccination protects the individual; high vaccination rates protect the population as a whole and particularly those at risk. Vaccination decisions must, therefore, be made on the basis of a public consensus-oriented discussion. Against this background, the vaccination idea should be a permanent part of educational canons.
In Germany there have been intense discussions about measles vaccination and, as a consequence, the “Law for the Protection against Measles and for Strengthening Vaccination Prevention (Measles Protection Act)” was passed. The Measles Protection Act has now been in force since 1 March 2020 and has far-reaching consequences for day-care centres for two reasons. First, children and staff in day-care centres must prove that they have been vaccinated against measles before being admitted to the centre. Second, day-care facilities are obliged to notify the local health authority if sufficient proof of measles vaccination is not provided for a child in the day-care facility. This shift in responsibility for the control of the vaccination status poses a great threat to the relationship of trust between parents and educational staff.
One of the most hotly debated topics in Romania in recent years has been the vaccination of children, especially in relation to the measles epidemic that began in 2016 and continues to this day. Using a discourse analytic perspective, this article addresses the main interpretative repertoires regarding the vaccination of children displayed in interview situations by two categories of parents, namely those who decided to vaccinate their children and those who refused to vaccinate their children. Regarding the first group, I have identified the following repertoires: (1) the repertoire of “I trust doctors, I trust science” as a repertoire of expressing total trust; (2) the repertoire of hypocrisy and ridicule in relation to “vaccine refusers” and (3) the repertoire of the absurdity of anti-vaccine theories. These repertoires come together into a broader discursive framework of epistemic superiority. The second group of parents (those who decided to refuse vaccination) developed a series of sub-repertoires to substantiate a rational, responsible and loving parent’s identity. I conclude that although we are witnessing a dynamic dialogic construction, at present the repertoires are constructed in a way that cancels out a possible dialogue between the two groups. On the one hand, those who support vaccination do so from a position of epistemic superiority, accusing vaccine refusers of lack of reason and education. On the other hand, those who refuse vaccination construct hypertrophied and complex repertoires of responsibility, rationality and affectivity meant to replace the legitimacy of scientific, medical and administrative institutions as a basis for parental decision making.
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