The highly individualistic nature of Western culture may foster lower levels of collectivist behavior270, like prosocial vaccination. For example, a large-scale experiment showed that participants with a collectivistic cultural background showed more prosocial vaccination motivation compared to participants with a individualistic cultural background271. Social aspects of vaccination are critical, since protection is only guaranteed when the frequency of vaccinated individuals reaches disease-specific herd immunity thresholds272,273. Interestingly, a Belgian study found that the social orientation of “vaccine hesitant” individuals is more tuned to individualistic inequality274. Nonetheless, in cultures that lack prosocial cultural background that motivate vaccination as a social decision, communicating the prosocial benefits of “herd immunity” results in improved willingness to vaccinate275. Herd immunity is a collective good and relies on the moral obligation of the individuals participating in that collective. However, problems arise when parents have to decide whether to vaccinate their children, since they have moral obligation to the safety of their children276. In this regard, herd immunity is a “public good” in the sense that it is not possible to exclude someone from benefitting from herd immunity once it is established. As a result, some parents argue their moral obligation to protect their children from risk of harm is high enough to free ride the benefits imposed by others through herd immunity276. This conflict has driven collectives to consider mandatory vaccination277 with the reasoning that participation in the benefits of a society comes with the moral obligation and sacrifice for the greater good278,279. As Poland et al. put it: “Ultimately, society must recognize that science is not a democracy in which the side with the most votes or the loudest voices gets to decide what is right.”280
However, mandatory vaccination has previously been shown to increase polarization between government and vaccine-skeptics277,281–284.
Curious still? Read on!
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271 Böhm R, Betsch C, Korn L, Holtmann C. Exploring and Promoting Prosocial Vaccination: A Cross-Cultural Experiment on Vaccination of Health Care Personnel. Biomed Res Int 2016; 2016: 6870984.
272 Fine P, Eames K, Heymann DL. “Herd Immunity”: A Rough Guide. Clin Infect Dis 2011; 52: 911–916.
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278 Caplan A. Liberty has its responsibilities: holding non-vaccinators liable for the harm they do. Hum Vaccin Immunother 2013; 9: 2666–2667.
279 Ropeik D. How society should respond to the risk of vaccine rejection. Hum Vaccin Immunother 2013; 9: 1815–1818.
280 Poland GA, Jacobson RM. The Age-Old Struggle against the Antivaccinationists. N Engl J Med 2011; 364: 97–99.
281 Omer SB, Betsch C, Leask J. Mandate vaccination with care. Nature 2019; 571: 469–472.
282 Gostin LO. Mandatory HPV Vaccination and Political Debate. JAMA 2011; 306: 1699–1700.
283 Gostin LO, DeAngelis CD. Mandatory HPV VaccinationPublic Health vs Private Wealth. JAMA 2007; 297: 1921–1923. 284 Dubov A, Phung C. Nudges or mandates? The ethics of mandatory flu vaccination. Vaccine 2015; 33: 2530–2535.
Sjoerd's thoughts on academic vaccine research 