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Taming the fear of voice: Dilemmas in maintaining a high vaccination rate in the Netherlands

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  • Geelen, Els
  • van Vliet, Hans
  • de Hoogh, Pieter
  • Horstman, Klasien

Abstract

In the context of international public debates on vaccination the National Institute for Public Health and the Environment (RIVM), the Dutch public health body responsible for the National Immunization Programme (NIP), fears that the high vaccination rate of children in the Netherlands obscures the many doubts and criticisms parents may have about vaccination. The question arises as to how the robustness of this vaccination rate and the resilience of the NIP can be assessed. To answer this question, we explore the vaccination practices and relationships between professionals and parents using qualitative methods. Drawing on Hirschman's concepts of exit, voice and loyalty, we distinguish between two different approaches to vaccination: one which enforces parental loyalty to the vaccination programme, and one which allows for voice. The analysis shows that due to their lack of voice in the main vaccination setting, parents' considerations are unknown and insight into their loyalty is lacking. We argue that the Dutch vaccination programme is caught between the insecurity of enforced parental loyalty to the NIP and the insecurity of enabling parental voice and negotiating space. We conclude that to increase the resilience of the NIP, experimenting with voice and exit is inevitable.

Suggested Citation

  • Geelen, Els & van Vliet, Hans & de Hoogh, Pieter & Horstman, Klasien, 2016. "Taming the fear of voice: Dilemmas in maintaining a high vaccination rate in the Netherlands," Social Science & Medicine, Elsevier, vol. 153(C), pages 12-19.
  • Handle: RePEc:eee:socmed:v:153:y:2016:i:c:p:12-19
    DOI: 10.1016/j.socscimed.2016.01.051
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    References listed on IDEAS

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    2. Casiday, Rachel Elizabeth, 2007. "Children's health and the social theory of risk: Insights from the British measles, mumps and rubella (MMR) controversy," Social Science & Medicine, Elsevier, vol. 65(5), pages 1059-1070, September.
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    Cited by:

    1. Hein de Vries & Wouter Verputten & Christian Preissner & Gerjo Kok, 2022. "COVID-19 Vaccine Hesitancy: The Role of Information Sources and Beliefs in Dutch Adults," IJERPH, MDPI, vol. 19(6), pages 1-17, March.

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