Understanding vaccine hesitancy in relation to psychological trauma

Abstract

Some Australians are hesitant to vaccinate themselves or their children. While past experiences have been suggested to play a role in vaccine hesitancy, the role of traumatic events has been largely overlooked. This thesis studied the relationship between vaccine hesitancy and psychological trauma. It aimed to add to how vaccine hesitancy is understood, and to inform the improvement of vaccination interventions and services.

To consolidate existing evidence, a systematic review was conducted followed by a qualitative exploration to understand the human experience. Grounded theory methodology was used to analyse interviews of non-vaccinating parents who had experienced medical trauma. To quantify interview findings, a cross-sectional survey of 1050 Australian adults yielded findings about how vaccination-related and non-vaccination-related traumatic events relate to hesitancy. To investigate vaccine hesitancy in older Australians, a priority group in the National Immunisation Strategy, survey data from the Sax Institute’s 45 and Up study were analysed.

Taken together, findings suggested that;(i) associations exist between traumatic events and vaccination decisions; (ii) both real and perceived vaccine threats contribute to hesitancy; and(iii) witnessed or recounted traumatic events can affect vaccination decisions and have a mixed relationship with vaccination intention. With input from a provider reference group, this thesis culminated in the development of trauma-informed guidance for vaccination services.

This thesis contributes knowledge on which future studies can build. It suggests that there is a need to address concerns about vaccination that have no sound scientific basis and echoes the idea that negative vaccination narratives can perpetuate hesitancy. It posits a preliminary theory for how traumatic events may affect vaccine hesitancy and concludes that taking a trauma-informed approach to vaccination may facilitate general respect of individual histories.