The Social Context of Vaccine Resistance: How Culture Influences the Timing and Prevalence of Vaccination

详细信息   

• 作者：Blakeslee ; Laura
• 学历：Doctor
• 年：2014
• 关键词：Social sciences ; Health and environmental sciences
• 导师：Palloni,Alberto B.,Carlson,Marcia J.
• 毕业院校：The University of Wisconsin
• Department：Sociology - LS
• 专业：Sociology;Epidemiology;Demography
• ISBN：9781321173758
• CBH：3635979
• Country：USA
• 语种：English
• FileSize：11235874
• Pages：263

文摘

Over the past two centuries,vaccines helped bring about an unprecedented decline in human morbidity and mortality from infectious disease. Yet,ever since the smallpox vaccine was first developed,some have resisted vaccines,risking new outbreaks of once-eliminated infections. This research investigates the history of vaccine development and resistance,illustrates their influence on infectious disease incidence,offers theory and social context to explain recent trends in resistance,and conducts two empirical studies to examine how culture influences the timing and prevalence of vaccination in the United States today. Wakefield et al. (1998),falsely linking Measles-Mumps-Rubella vaccine with autism,sparked the current culture of resistance,leading many parents to delay or refuse vaccines and leaving clusters of children susceptible to vaccine-preventable outbreaks. Chapter 2 conducts an event history analysis to examine whether US resistance to MMR (critical proportions unvaccinated,and odds of being unvaccinated) rose over time or varied by socioeconomic status and cultural context. MMR resistance grew recently,with delays especially among boys and White children,large and western households;highly educated and married mothers also delayed,but from lower levels of resistance. With current seasonal flu and Tdap vaccination rates too low to prevent influenza and pertussis outbreaks,mandatory immunization is increasingly becoming employer policy for many healthcare workers (HCWs). However,as opinion leaders with an opportunity to influence vaccine attitudes among lay adults,HCWs are a priority group for vaccination beyond their own potential to contract and transmit infectious disease. Chapter 3 uses Structural Equation Modeling to estimate the influence of HCW knowledge and attitudes (perceived threat of disease,vaccine benefits,vaccination barriers,and normative expectations) on the odds of vaccination among clinicians,pharmacists and nurses in Wisconsin. Cultural norms strongly encourage seasonal flu and Tdap vaccination and threat of pertussis increases Tdap rates,while barriers reduce vaccination overall. Understanding the social context of vaccine resistance offers an opportunity to develop policies and programs that encourage vaccination and counter resistance by engaging local interests in the vaccine debate,balancing individual and community health concerns,and garnering support for effective solutions that reduce outbreaks of infectious disease.