VAX-TRUST Ethnography
Research type
Research Study
Full title
VAX-TRUST: Addressing Vaccine Hesitancy in Europe (Ethnographic Study)
IRAS ID
315222
Contact name
Pru Hobson-West
Contact email
Sponsor organisation
University of Nottingham
Duration of Study in the UK
0 years, 4 months, 1 days
Research summary
Research Summary
The VAX-TRUST research programme aims to develop educational resources based on in-depth qualitative evidence that will assist healthcare professionals in their communication with parents about childhood vaccination. The study under review here involves the ethnographic observation of appointments in which a healthcare professional discusses and administers childhood vaccination. These observations will take place in two general practice surgeries in the East Midlands, with a researcher being on-site for 90 hours split between the two practices.
During these observations, the researcher will collect data in the form of handwritten notes on the interaction between the healthcare professional, parent/guardian, and child present. These notes will cover the verbal language used by participants (such as the content or tone of speech), nonverbal aspects of the interaction such as body language, and the characteristics of the site itself (such as the furniture or aesthetics of the practice).The findings from these observations will provide important insights for the future design of the locally tailored interventions as part of the VAX-TRUST programme, for example by highlighting whether there are particular aspects of communication or the appointment that parents/guardians or children respond to positively, whether there are inconsistencies in how appointments are carried out with different participants, and whether and how parents/guardians express concern about vaccines during the appointment.
The aim of this study, and other separate pieces of qualitative research being undertaken as part of VAX-TRUST, is to understand more about how childhood vaccination operates as a social event. These ethnographic observations will provide insights into the nature of these vaccination interactions that would not be available from other methods such as qualitative interviews or focus groups.
Summary of Results
Childhood immunisation is an important pillar of preventive public health, and healthcare professionals play a key role in discussing the benefits and risks of vaccination with parents and carers. Existing social scientific research aimed at understanding vaccination practices tends to use interviews or questionnaires with parents or with healthcare professionals. This study is unusual in using ethnographic observation of vaccine appointments. Two primary care clinics in the East Midlands region of the UK were observed between June-August 2022. The study is part of the wider VAX-TRUST research programme which is funded by the European Union Horizon 2020 programme.
The analysis suggests that childhood immunisation appointments should be understood as a rich and complex social occasion. Whilst the central task of the appointment is the delivery of a vaccine or vaccines to an individual child, the appointment also involves several other actions on the part of the healthcare professional, in order to manage their relationship with the child’s parent or carer. These actions are designed to mitigate parental distress at their child’s discomfort by providing advice on the management of vaccine side effects (for example via pain relief medications); by encouraging future adherence to the vaccination schedule by booking future appointments; and by providing advice or a listening ear for other parental/carer concerns. Whilst there were some differences in how the two observed clinics operated, in both cases these multiple activities are enabled via a careful choreographing of the various tasks within the appointment, such as drawing up the vaccines and filling out paperwork.
Overall, our ongoing analysis points to the potential value of the vaccination appointment as a more generalised engagement between healthcare services and young children. What is evident from observation, however, is that it is rare for detailed vaccine hesitancy to be expressed during these appointments. Whilst the appointments are clearly an important occasion for the receipt of vaccines and wider discussion of paediatric health more broadly, they are not necessarily operating as a focal point for in-depth discussion about vaccination.REC name
West Midlands - Solihull Research Ethics Committee
REC reference
22/WM/0129
Date of REC Opinion
31 May 2022
REC opinion
Favourable Opinion