Activists in the “vaccination safety” movement, or “anti-vaxxers” as they are often called derisively, have recently been highly visible in the media and in conversations among parents, and between parents and medical professionals. Andrea Kitta’s book constitutes a critical intervention into the discourse surrounding vaccination as a public health concern. This, her first book, is riveting and has implications for folklore research, but also very practical applications for public health policy and practice. Kitta’s project is, as she describes it, “an exploration of the vernacular beliefs and practices that surround decisions not to vaccinate with the primary aim of providing concrete recommendations for improving inoculation promotion programs” (2). She thoughtfully and considerately does so without condemnation, but rather with compassion and the perspective that these narratives express very real concerns that only intensify when dismissed out of hand.
The book is thoroughly researched, featuring interviews with parents and medical professionals and textual analysis on website message boards and articles, drawing heavily on other research on these issues. Where she makes her strongest original argument is in articulating how an understanding of the form, content, and transmission of legend, rumor, and belief around vaccination will allow the concerns expressed in these to be addressed and dealt with in a real way in order to increase the public good. Her introduction, in fact, exemplifies the strength and import of this book; she grounds herself thoroughly in folklore studies, particularly legend, which serves as a helpful reminder for those in the field not so immersed in the scholarship. Moreover, this contextualization gives public health scholars and professionals a nuanced primer in legend studies, which is a new lens through which they can view this material. Her discussion of the history of both vaccines and the anti-vaccine movement is then readable in this context, and her ensuing chapters benefit from the grounding she gives to readers in diverse fields.
Kitta’s second chapter traces the history of vaccination, demonstrating that contemporary concerns about inoculation have remained fairly constant since the earliest developments of vaccination. Moreover, she points out that discursive strategies have remained largely unchanged, both in those resisting vaccines and in characterizations by pro-vaccinators of those who are anti-vaccine. She then grounds her research in folkloristics, examining the genres and traditional forms used to present vaccination narratives, most commonly contemporary legend, rumor, personal experience narratives, or some combination of these. She also comments on the intertextual nature of such narratives as they are transmitted via word of mouth, the internet, and broadcast media.
In chapter 3, Kitta analyzes the folkloric content of the narratives. This is one of the strongest sections of the book, combining narrative analysis of both form and content and drawing out the underlying tensions and fears enacted through these narratives and their implications for making health decisions. I did want her to bring together more of the threads from this chapter to explain more explicitly why the content of these narratives is so appealing in such a wide-reaching way.
One crucial but too often ignored aspect of this issue is examined in chapter 4: the medical community’s perception—and occupational folklore—surrounding the medical and ethical issues involved in vaccination and communication with patients. Kitta approaches this material with a compassion for the function of legends and the challenges that health professionals face, while still dispassionately analyzing how these perceptions and legends can demean patients and parents. She concludes that ethics and ideology are important, but that lay perception of risks must be considered beyond medical professionals’ own comfort levels.
In the fifth and final chapter, Kitta demonstrates how risk perceptions lie at the heart of vaccine refusals, and how public health programs and medical professionals might address such concerns in a practical and effective way. It is here that her book performs its standout intervention, by making concrete recommendations to improve public health outcomes.
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[Review length: 642 words • Review posted on May 17, 2017]