Sociocultural concepts of pandemic influenza and determinants of community vaccine acceptance in Pune, India

Abstract

Vaccines are considered one of public health’s greatest achievements. Yet, public concerns and hesitancy towards acceptance of vaccines has been noted around the world for various vaccines. Limited vaccine uptake against influenza A (H1N1) was a problem during the 2009-2010 pandemic. Ensuring the ability to rapidly produce large quantities of an efficacious vaccine has been a focus of pandemic preparedness at the global and national levels. Notwithstanding the importance of these preparedness measures, its availability and clinical efficacy alone may not be sufficient for the vaccine to be effective at a community level. Culture has a powerful influence on the understanding of sickness and illness-related behaviour. The framework of cultural epidemiology used in this thesis integrates the local validity of anthropology and the explanatory power of epidemiology to clarify the cultural basis of vaccine hesitancy and acceptance. Despite cross-cultural differences and an acknowledged need for country-specific studies, relatively little research has focussed on pandemic influenza vaccine hesitancy in lower income settings. A mixed-methods research study was conducted in urban and rural Pune, a hotspot of the influenza pandemic in India. The aim was to study local sociocultural features of illness and determinants of pandemic influenza vaccine acceptance from a community perspective. This work is a contribution to global advances in the study of vaccine hesitancy and it underscores the value of sociocultural study and community preferences in planning effective vaccine action.