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“有什么道理吗?”拒绝大规模接种疫苗:2009 - 2010年瑞典甲型H1N1流感大流行背景下的主观重新解读

'Rhyme or reason?' Saying no to mass vaccination: subjective re-interpretation in the context of the A(H1N1) influenza pandemic in Sweden 2009-2010.

作者信息

Lundgren Britta

出版信息

Med Humanit. 2015 Dec;41(2):107-12. doi: 10.1136/medhum-2015-010684. Epub 2015 Jun 15.

Abstract

During the swine flu pandemic of 2009-2010, all Swedish citizens were recommended to be vaccinated with the influenza vaccine Pandemrix. However, a very serious and unexpected side effect emerged during the summer of 2010: more than 200 children and young adults were diagnosed with narcolepsy after vaccination. Besides the tragic outcome for these children and their families, this adverse side effect suggests future difficulties in obtaining trust in vaccination in cases of emerging pandemics, and thus there is a growing need to find ways to understand the complexities of vaccination decision processes. This article explores written responses to a questionnaire from a Swedish folk life archive as an unconventional source for analysing vaccine decisions. The aim is to investigate how laypersons responded to and re-interpreted the message about the recommended vaccination in their answers. The answers show the confusion and complex circumstances and influences in everyday life that people reflect on when making such important decisions. The issue of confusion is traced back to the initial communications about the vaccination intervention in which both autonomy and solidarity were expected from the population. Common narratives and stories about the media or 'big pharma capitalism' are entangled with private memories, accidental coincidences and serendipitous associations. It is obvious that vaccination interventions that require compliance from large groups of people need to take into account the kind of personal experience narratives that are produced by the complex interplay of the factors described by the informants.

摘要

在2009 - 2010年猪流感大流行期间,瑞典建议所有公民接种流感疫苗“大流行疫苗”(Pandemrix)。然而,在2010年夏天出现了一种非常严重且意想不到的副作用:200多名儿童和年轻人在接种疫苗后被诊断出患有发作性睡病。除了给这些孩子及其家庭带来的悲惨后果外,这种不良副作用表明,在新出现的大流行情况下,未来在获得人们对疫苗接种的信任方面会存在困难,因此越来越需要找到方法来理解疫苗接种决策过程的复杂性。本文探讨了来自瑞典民俗生活档案中对一份问卷的书面回复,将其作为分析疫苗决策的非常规资料来源。目的是调查外行人在回答中如何回应并重新解读关于推荐接种疫苗的信息。答案显示了人们在做出如此重要决策时所反思的日常生活中的困惑、复杂情况及影响因素。困惑问题可追溯到关于疫苗接种干预的最初宣传,当时期望民众既保持自主又团结协作。关于媒体或“大型制药资本主义”的常见叙述和故事与个人记忆、偶然巧合及意外联想交织在一起。显然,要求大量人群遵守的疫苗接种干预措施需要考虑到由受访者所描述的各种因素复杂相互作用产生的个人经历叙述。

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本文引用的文献

1
Narrating narcolepsy--centering a side effect.讲述发作性睡病——聚焦一种副作用。
Med Anthropol. 2015;34(2):150-65. doi: 10.1080/01459740.2014.962694.
2
Attitudes to vaccination: a critical review.接种态度:批判性回顾。
Soc Sci Med. 2014 Jul;112:1-11. doi: 10.1016/j.socscimed.2014.04.018. Epub 2014 Apr 16.
3
The politics and anti-politics of infectious disease control.传染病控制的政治学与反政治学
Med Anthropol. 2014;33(3):198-205. doi: 10.1080/01459740.2014.892484.
4
Social capital and immunisation against the 2009 A(H1N1) pandemic in Sweden.社会资本与瑞典人接种 2009 年甲型 H1N1 流感疫苗
Scand J Public Health. 2013 Dec;41(8):853-9. doi: 10.1177/1403494813494975. Epub 2013 Jul 10.

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