It always has to come down to individual choice . Vaccination decision-making among privileged parents in South Africa
With most vaccine hesitancy research being performed in high income countries, little is understood about the phenomenon in low- and middle-income regions, including South Africa. Seeking to understand a gap in vaccine hesitancy research, this qualitative study examined the lived experiences and perspectives on vaccination, of parents from privileged communities, in the Western Cape, South Africa. Privilege was defined as individuals who have an educational level above high school, and through self-report had experienced no major financial difficulties, due to the COVID-19 pandemic or other reasons, that would have resulted in impact on standard of living, children's educational institution, or healthcare access. Conducted during the South African COVID-19 vaccine roll-out, from March to June 2022, the study explored how these parents make decisions about vaccination, including routine childhood vaccination, influenza and human papillomavirus vaccines, focusing on the COVID-19 vaccine. Analysis of transcripts from 14 semi-structured individual interviews was performed. Data were analysed using thematic analysis and framed within the structure of the socioecological model. Results of the study demonstrate that although privilege does not dictate whether or not an individual chooses to vaccinate, privilege impacts vaccination decision making and outcomes in both explicit and implicit ways, including lifestyle, accessibility, insight into the experience of less privileged individuals, and the entitlement of choice. Analysis of the data resulted in the classification of participants into three broad categories of vaccination decision-making processes: (1) the dutiful parent, (2) the sceptical parent, and (3) the uncertain parent. Within these categories, privilege occupies a particular place in the variable and nuanced differences in parents' vaccination decisionmaking processes. It is crucial to understand how privileged individuals determine health care choices, as these decisions can have far-reaching impacts on less privileged communities with more limited access to resources and health care
Networked Digital Library of Theses and Dissertations
Department of Public Health and Family Medicine