Immunisation policy: from compliance to concordance?

Immunisation has proved a highly effective public health policy. However, it has come under public suspicion at times, with large falls in pertussis immunizations in the 1980s and smaller falls in measles, mumps and rubella (MMR) vaccine uptake recently. Immunisation scares have also occurred in other countries. This discussion paper explores the concepts of herd immunity, altruism, and informed consent. Historical, quantitative, and qualitative research on the sociology of immunisation is reviewed. Recent research has shown that the concerns of parents include a loss of trust in health professionals and increasing worries about side effects. The sociologist Streefland is the leader of the World Health Organisation Sociology and Immunisation Project. His concept of the five perspectives on immunisation is explained. Concordance is then described as a dialogue based on mutual respect between different perspectives. Finally, some suggestions are made for immunisation policy in the UK. Immunisation policy should move from the current situation, which largely assumes the passive compliance of the population, to a policy where people are actively involved and their views respected.