Medical Knowledge and Uncertainty: Health Professionals’ Narratives of Childhood Vaccines

• Author / Creator

  Manca, Terra A

• In recent years, narratives about various embellished and imaginary risks of vaccination have come under criticism because of their implications for the widespread acceptance of vaccines. Criticisms of these narratives often accompany assumptions that all mainstream health professionals accept, value, and promote vaccination. Most health professionals, however, are socially situated between vaccine experts (such as immunologists) and the wider public. In fact, since the first smallpox vaccine, professionals and the public have expressed somewhat varied understandings of the costs and benefits associated with vaccines. Health professionals’ views are more uniform than they were in the late 1800s, but most of the literature about vaccine anxieties focuses on public and patient perspectives. While some studies have analyzed health professionals’ understandings of vaccination, the focus on lay perspectives helps maintain assumptions that all health professionals are aware of the current state of vaccine knowledge and fully accept the necessity of vaccination. This dissertation challenges assumptions about health professionals’ relationship to vaccination through the analysis of thirty-four semi-structured interviews with twenty-seven physicians and seven nurses who were practicing in central or southern Alberta. During these interviews, health professionals described their experiences, knowledge, and uncertainties regarding vaccines. Interviews centered around four separate but related topics, which comprise the bulk of this dissertation. First, professionals accounted for what they perceived to be the risks and uncertainties associated with vaccination, pharmaceutical products, and vaccine policies. Second, interviewees appeared to use tactics to maintain their support of vaccination despite their perception of the risks or uncertainties associated with specific vaccines. Third, while managing their uncertainties, interviewees provided individual accounts of themselves that emphasized their own professionalism. These accounts often involved a comparison to other professionals and patients, who they presented as misinformed. Fourth, interviewees problematized the role of media, social networks, and celebrity endorsement in public conceptions and fears of vaccines. Throughout interviews, health professionals used personal stories about vaccine risks and benefits to express their role, the risks of disease, and potential risks associated with vaccination. Indeed, many people, including health professionals, share and learn about vaccines through various forms of narrative, which convey both information and emotion. As such, this dissertation offers some insight into the role of narrative in the communication of medical knowledge, the potential diversity in health professionals’ understandings of a mundane public health treatment, and the ways in which individuals create professional presentations of self when they are situated between experts and the public.

• Subjects / Keywords

  • Immunization
  • Narrative Analysis
  • Cost Benefit Analysis
  • Anxiety
  • Medical Uncertainty
  • Risk
  • Qualitative Methods
  • Public Health
  • Account of Oneself
  • Vaccinations

• Graduation date

  Fall 2017

• Type of Item

  Thesis

• Degree

  Doctor of Philosophy

• DOI

  https://doi.org/10.7939/R36688Z72

• License

  This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.