restricted access Trust in Institutions, Science and Self—the Case of Vaccines
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Trust in Institutions, Science and Self—the Case of Vaccines

Controversy has surrounded vaccines and vaccination since their introduction at the end of the 18th century. Early opposition centered on fear and distrust about introducing something foreign into the body, violation of the “laws of God,” and rejection of science. (Nelson & Rogers, 1992) Interestingly, as Wolfe and Sharp (2002) showed, there are “uncanny similarities” (p. 431) between contemporary arguments against vaccines and those used since the 19th Century. Both then and now, vaccine opponents have argued (among other things) that:

  • • vaccines cause injury/death;

  • • there is a conspiracy or cover–up those dangers;

  • • profit has subverted public health; and

  • • safer, more natural alternatives to vaccination exist.

Today’s arguments come from different places than their 19th Century counterparts, because the social world has changed fundamentally between then and now, though all can be found in these parent narratives. Vaccines—specifically childhood vaccines—continue to be a site of heated contention, despite near–record compliance rates (National Vaccine Advisory Committee, 2013). Mass vaccination demands that parents place their children at some risk—however statistically small—to achieve a promised community benefit. My reading of these narratives reveals more than just support or opposition to vaccines, a parental calculus, or the recapitulation of historical arguments. It opens a small window into how parents today think about, accept, oppose, and justify their beliefs and actions. Vaccines have a social existence, and they “do” a lot more than their biological or epidemiological purposes intend. In the telling of each narrative here, parents describe a range of opinions, experiences, and explanations; what they share tells us about their attitudes towards rights, prevention, medicine, risk, science and—ultimately (and I argue, most importantly)—trust. Though everything in the narratives comes to us through the lens of vaccines and vaccine–related experiences, I’d argue that “trust issues” go far beyond the specific case of vaccines. Even generalized social anxiety prepares the ground for the growth of distrust.

The twelve narratives distribute themselves across the pro–to anti–vaccination spectrum. That pro/anti division is far less important (or interesting) than the principles that undergird the narratives, the specific stories they tell, and the relationships they trace among knowledge, experiences, and attitudes. I find the social/structural context that produced the narratives far more compelling than where they may fall on some scale of “support” for vaccines. For those interested in creating changes in people’s opinions and actions about vaccine, this may not be very helpful, at least in the short term.

Nevertheless, health professionals can benefit from the kinds of “information” these parents are [End Page 199] sharing—not simply to be more effective in achieving policy goals, but also for their formulation, as well as for help in understanding what lies behind the range of attitudes about vaccines, whether in clinical situations, in policy disputes, or in public controversies. Once weakened at the social level, trust can be very difficult to rebuild. This commentary, then, is closer to an exercise in what Max Weber termed verstehen (understanding), rather than erklären (explaining), which is what most science seeks. If we misconstrue the bases for parents’ worldviews, then efforts to engage will be based on a kind of conversation–at–cross–purposes, and may very well increase distrust. The range of trust expressed in these narratives reaches from implicit (or revealed) faith in science to a sense of angry betrayal.

An interpretation of the narratives using the lens of trust provides a parsimonious basis to understand opposition to—and support for—vaccines. It locates the problem outside the individual, and situates the underlying causes in the broad social/structural and cultural trends of contemporary society—part of the general response to an impersonal modernity (Giddens 1990; Lewis & Weigert, 2012) that may seem to impose its will without consideration or mercy. That, at any rate, is how they look from my perspective—as a historical sociologist interested in vaccines, rumors and conspiracy theories and the cultural provenance of scientific evidence.

Some Notes on Methodology

These narratives are not representative of anything except the views and ideas of the individuals who authored them: they...