Abstract
A series of vaccine incidents have stimulated vaccine hesitance in China over the last decade. Many scholars have studied the institutional management of these incidents, but a qualitative study of stakeholders’ perspectives on vaccine hesitancy in China is missing. To address this lacuna, we conducted in-depth interviews and collected online data to explore diverse stakeholders’ narratives on vaccine hesitance. Our analysis shows the different perspectives of medical experts, journalists, parents, and self-defined vaccination victims on vaccination and vaccination hesitance. Medical experts generally consider vaccines, despite some flaws, as safe, and they consider most vaccine safety incidents to be related to coupling symptoms, not to vaccinations. Some parents agree with medical experts, but most do not trust vaccine safety and do not want to put their children at risk. Media professionals, online medical experts, and doctors who do not need to align with the political goal of maintaining a high vaccination rate are less positive about vaccination and consider vaccine hesitance a failure of expert–lay communication in China. Our analysis exhibits the tensions of medical expert and lay perspectives on vaccine hesitance, and suggests that vaccination experts ‘see like a state’, which is a finding consistent with other studies that have identified the over-politicization of expert–lay communication in Chinese public discourse. Chinese parents need space to express their concerns so that vaccination programs can attune to them.
Highlights
Vaccine hesitance, which is defined by the World Health Organisation (WHO) as a delay in the acceptance or refusal to vaccinate, despite the availability of vaccination services, has been reported in more than 90% of countries in the world [1]
Notwithstanding various vaccine safety incidents over the last few years, a Center for Disease Control (CDC) expert, two clinicians, and two parents explained that there was no structural and fundamental safety issue with domestic vaccines. They claimed that the efficacy of vaccines had been undermined by illegal corporate production, but that the safety of vaccines themselves was qualified (ID 1, 15,16); strict electronic monitoring and a risk response system had been established by the state, so unqualified vaccines are rapidly controlled and vaccine safety incidents no longer occur
Journalists and online medical experts mentioned the same risks in vaccine safety, vaccination organizations, and crisis responses as these parents, and they considered parental mistrust in the National Immunisation Programme (NIP) to be a result of a failure of science popularization in China
Summary
Vaccine hesitance, which is defined by the World Health Organisation (WHO) as a delay in the acceptance or refusal to vaccinate, despite the availability of vaccination services, has been reported in more than 90% of countries in the world [1]. Category 1 vaccines include vaccines to prevent diseases, such as the hepatitis B vaccine, polio vaccine, and diphtheria–tetanus–pertussis (DTP) vaccine. Category 2 vaccines are optional vaccines that have to be paid for by the parents. The vaccines in this category include, for instance, vaccines to prevent human papillomavirus (HPV), mumps, rubella, pneumococcus, and rotavirus [2]), vaccine hesitance exists in China. In 2010, nearly 100 children suffered disability or death caused by adverse reactions to vaccinations in Shanxi province [4]. In 2013, eight babies died of adverse reactions after hepatitis vaccinations in southern China [5], and in 2016, many vaccines with unqualified cold storage entered the market in Shandong province, resulting in public anxiety [5]. In 2018, Changchun Changsheng Biotechnology Co., Ltd. produced invalid DTP vaccines, Vaccines 2020, 8, 650; doi:10.3390/vaccines8040650 www.mdpi.com/journal/vaccines
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