Stigmatized for standing up for my child: A qualitative study of non-vaccinating parents in Australia

Kerrie E Wiley; Julie Leask; Katie Attwell; Catherine Helps; Lesley Barclay; Paul R Ward; Stacy M Carter

doi:10.1016/j.ssmph.2021.100926

Stigmatized for standing up for my child: A qualitative study of non-vaccinating parents in Australia

SSM Popul Health. 2021 Sep 16:16:100926. doi: 10.1016/j.ssmph.2021.100926. eCollection 2021 Dec.

Authors

Kerrie E Wiley¹, Julie Leask^{1

2}, Katie Attwell³, Catherine Helps², Lesley Barclay⁴, Paul R Ward⁵, Stacy M Carter⁶

Affiliations

¹ Sydney School of Public Health, Faculty of Health and Medicine, University of Sydney, Australia.
² Sydney Nursing School, Faculty of Medicine and Health, University of Sydney, Australia.
³ School of Social Sciences, Faculty of Arts, Business, Law and Education, University of Western Australia, Australia.
⁴ University Centre for Rural Health, Sydney School of Public Health, University of Sydney, Australia.
⁵ College of Medicine and Public Health, Flinders University, Adelaide, Australia.
⁶ Australian Centre for Health Engagement, Evidence and Values (ACHEEV), University of Wollongong, Australia.

Abstract

Background: Vaccine refusal is highly polarizing in Australia, producing a challenging social landscape for non-vaccinating parents. We sought to understand the lived experience of non-vaccinating parents in contemporary Australia.

Methods: We recruited a national sample of non-vaccinating parents of children <18 yrs, advertising on national radio, in playgrounds in low vaccination areas, and using snowballing. Grounded Theory methodology guided data collection (via semi-structured interviews). Inductive analysis identified stigmatization as a central concept; stigma theory was adopted as an analytical lens.

Results: Twenty-one parents from regional and urban locations in five states were interviewed. Parent's described experiences point to systematic stigmatization which can be characterized using Link & Phelan's five-step process. Parents experienced (1) labelling and (2) stereotyping, with many not identifying with the "anti-vaxxers" portrayed in the media and describing frustration at being labelled as such, believing they were defending their child from harm. Participants described (3) social "othering", leading to relationship loss and social isolation, and (4) status loss and discrimination, feeling "brushed off" as incompetent parents and discriminated against by medical professionals and other parents. Finally, (5) legislative changes exerted power over their circumstances, rendering them unable to provide their children with the same financial and educational opportunities as vaccinated children, often increasing their steadfastness in refusing vaccination.

Conclusion: Non-vaccinating Australian parents feel stigmatized for defending their child from perceived risk of harm, reporting a range of social and psychological effects, as well as financial effects from policies which disadvantaged their children through differential financial treatment, and diminished early childhood educational opportunities. While it might be argued that social stigma and exclusionary policies directed a small minority for the greater good are justified, other more nuanced approaches based on better understandings of vaccine rejection could achieve comparable public health outcomes without the detrimental effect on unvaccinated families.

Keywords: Australia; Childhood vaccination; Immunization; Public health; Qualitative research; Stigma; Vaccine refusal.