2.11 Vaccine Non-Compliance

The phenomenon of non- compliance with vaccination programmes has received much attention in the medical literature and government agencies, such as the Health Education Authority  (Bedford  and Kendall, 1998).

Hershey, Asch, Thumasathit, Meszaros and  Waters (1994) have highlighted  three distinct mental models employed by parents when deciding whether or not to accept the pertussis vaccination on behalf of their child. First, they described the “Bandwagoning logic” which refers to parents who vaccinate their children by following the actions of the vast majority. Secondly, they described the “Altruistic logic” which  is employed by those who accept vaccination by taking personal risks if the community will benefit from their actions and finally “Free-riding” logic which was attributed to all refusing parents who purportedly believe they do not need to expose their children to the risk of vaccination because they are protected from the disease through herd immunity.

It is acknowledged that little is known about how the attitudes are formed by parents who refuse to have their children vaccinated  and how the decision is made (Bedford and Kendall, 1998; and Bostrom, 1996). The medical literature addressing this phenomenon, however, tends to dismiss ‘refusing’ parents as an ‘eccentric minority’ (Forrest, 1995).

According to Salisbury, Beverley and Miller (2002), the greatest threat to vaccination is the resistance to continuing vaccination in the face of declining prevalence of many infectious diseases and heightened fears over vaccine safety. Re-assurance of the public that vaccines are safe demands effective detection of vaccine-related side-effects and rigorous investigation of any safety concerns.