"Those who love, vaccinate": An Anthropological Perspective on HPV Vaccination in Brazil Público
Chiang, Ellen Dias De Oliveira (2015)
Abstract
Brazil launched an HPV immunization campaign in March of 2014. In less than 6 months, national uptake of the first dose surpassed 80%. Understanding the apparent acceptance of the HPV vaccine in Brazil gives insight into what sorts of factors drive vaccine uptake. Various theoretical frameworks have been developed to help explain, predict, and modify vaccination behavior. Some of these theories propose that biomedical knowledge has a primary influence on decisions to vaccinate. From this perspective, increased knowledge would correlate with increased vaccination. However, a growing body of literature strongly suggests that the provision of scientific knowledge about HPV and its vaccine is not sufficient to motivate parents to vaccinate their daughters. Instead, vaccination is context specific and parent perceptions are shaped by various social, political, and cultural factors that affect how biomedical information is interpreted, the meaning of HPV vaccination, and vaccine access. This study aimed to identify these distal influences and assess the role of HPV knowledge in determining the acceptability of HPV vaccination within a subset of 30 parents from São Paulo, Brazil. The results suggest that the widespread acceptance of the vaccine in São Paulo can be understood by examining the culture of vaccination from which the vaccine gains more than just a biomedical identity. HPV vaccination was portrayed as an act of parental love that provides both health and social insurance against the many unknowns that affect a child's health. This prevailing vaccination culture is mediated by trust in the Ministry of Health and healthcare workers. Thus HPV vaccination isn't just a matter of biomedicine; it intersects the realms of parenting, sexuality, gender roles, power structures, stigma, and social inequality. As hypothesized, these distal factors held more explanatory power for vaccine acceptability than parental knowledge levels. The findings indicate that attempts to understand or modify vaccination rates require the consideration of distal factors.
Table of Contents
I. Introduction 1
II. Methods 31
III. Results 35
IV. Discussion 62
V. Conclusion 72
VI. Appendix 73
VII. References 77
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