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因维护我的孩子而受到污名化:对澳大利亚未接种疫苗儿童家长的定性研究

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

作者信息

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

机构信息

Sydney School of Public Health, Faculty of Health and Medicine, University of Sydney, Australia.

Sydney Nursing School, Faculty of Medicine and Health, University of Sydney, Australia.

出版信息

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

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.

摘要

背景

在澳大利亚,拒绝接种疫苗的现象极具两极分化,给不接种疫苗的家长带来了具有挑战性的社会局面。我们试图了解当代澳大利亚不接种疫苗的家长的生活经历。

方法

我们在全国范围内招募了18岁以下儿童的不接种疫苗的家长样本,通过在全国性电台做广告、在低疫苗接种率地区的操场宣传以及滚雪球抽样的方式进行招募。扎根理论方法指导数据收集(通过半结构化访谈)。归纳分析确定污名化为核心概念;采用污名理论作为分析视角。

结果

对来自五个州的地区和城市的21位家长进行了访谈。家长们描述的经历表明存在系统性的污名化,这可以用林克和费伦的五步过程来描述。家长们经历了:(1)标签化和(2)刻板印象,许多人不认同媒体所描绘的“反疫苗接种者”,并对被贴上这样的标签表示沮丧,认为自己是在保护孩子免受伤害。参与者描述了(3)社会“他者化”,导致关系丧失和社会孤立,以及(4)地位丧失和歧视,感觉作为不称职的家长被“冷落”,并受到医疗专业人员和其他家长的歧视。最后,(5)立法变化对他们的处境产生了影响,使他们无法为孩子提供与接种疫苗的孩子相同的经济和教育机会,这往往增强了他们拒绝接种疫苗的坚定性。

结论

澳大利亚不接种疫苗的家长因保护孩子免受感知到的伤害风险而感到受到污名化,报告了一系列社会和心理影响,以及政策带来的经济影响,这些政策通过差别化的经济待遇使他们的孩子处于不利地位,并减少了幼儿教育机会。虽然可能有人认为,为了更大的利益而针对少数人的社会污名和排斥性政策是合理的,但基于对疫苗拒绝有更好理解的其他更细致入微的方法可以在不对未接种疫苗的家庭产生不利影响的情况下实现可比的公共卫生结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c81/8473775/676aca89ed46/gr1.jpg

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