Introduction

The role of immunization in controlling disease during childhood is, arguably, one of the most popular stories of scientific triumph and progress in the history of public health. Alongside the improvement of public sanitation, vaccination is acknowledged as one of the most important medical milestones since the mid-nineteenth century. Recent outbreaks of vaccine-preventable childhood diseases in Canada and elsewhere represent a particular challenge to this dominant cultural narrative and have been largely attributed to the emergence of a new class of vaccine-hesitant parents.

Introduced in the literature in approximately 2010, and gaining traction in the academic literature and in international and Canadian health policy and planning documents shortly thereafter, the term “vaccine hesitancy” (VH) describes instances when parents delay vaccination or vaccinate their children with some, but not all, recommended vaccines. Fueled by recent outbreaks of measles and other childhood diseases, the discourse of VH interprets any signs of individual hesitancy as a threat to full immunization that compromises herd immunity. Distinct from outright refusal, the discourse of VH marks an important shift in the way we speak and think about the long history of parental resistance to vaccination. Because concerns about vaccination are “at once bodily, social and political,” such shifts in the language and metaphors concerning health, risk and immunity provide an opportunity to explore broader cultural anxieties. These anxieties reflect tensions in how to best manage public health in neoliberal societies where collective well-being is conceptualized as the accumulation of free, yet responsible, individual choices that conform to public health expertise and guidelines. While VH transcends the dichotomy of vaccine acceptance versus refusal, it simultaneously multiplies the ways in which parents come to be defined and viewed as resistant or noncompliant and widens the approaches that are taken to identify and correct parental attitudes that are seen as faulty and misaligned with biomedical views of risk and public health perspectives on healthy living and responsible parenting. Paradoxically, this broadened approach to understanding vaccine uptake becomes recuperated easily into a polarized vision of public health in which any deviation from recommended vaccination practices is conflated with an anti-vaccination stance.