The Globalization of Risk and Risk Perception
Risk communication and vaccines is complex and the nature of risk perception is changing, with perceptions converging, evolving and having impacts well beyond specific geographic localities and points in time, especially when amplified through the Internet and other modes of global communication.
This article examines the globalization of risk perceptions and their impacts, including the example of measles and the globalization of measles, mumps and rubella (MMR) vaccine risk perceptions, and calls for a new, more holistic model of risk assessment, risk communication and risk mitigation, embedded in an ongoing process of risk management for vaccines and immunization programmes. It envisions risk communication as an ongoing process that includes trust-building strategies hand-in-hand with operational and policy strategies needed to mitigate and manage vaccine-related risks, as well as perceptions of risk.
KeywordsMeasle Risk Perception Risk Communication Immunization Programme Vaccine Coverage
No sources of funding were used to prepare this manuscript. Heidi Larson has received grants from the Bill & Melinda Gates Foundation, and an honorarium from Pfizer for lecturing (a one-off). Pauline Brocard Paterson has worked as a Research Fellow with Heidi Larson on the Bill & Melinda Gates Foundation grant. Ngozi Erondu has no conflicts of interest to declare.
This paper is part of a theme issue co-edited by Priya Bahri, European Medicines Agency, UK, and Mira Harrison-Woolrych, New Zealand Pharmacovigilance Centre, New Zealand, and no external funding was used to support the publication of this theme issue.
- 1.National Research Council. Improving risk communication. Washington, DC: National Academy Press, 1989Google Scholar
- 4.General recommendations on immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP). Preventing and managing adverse reactions: benefit and risk communication. MMWR Recomm Rep 2011; 60 (2): 1–64Google Scholar
- 5.Leach M, Fairhead J. Vaccine anxieties: global science, child health and society. London: Earthscan, 2007Google Scholar
- 6.Wildavsky A, Dake K. Theories of risk perception: who fears what and why?. Daedalus 1990; 119 (4): 41–60Google Scholar
- 8.Evans G, Bostrom A, Johnston RB, et al., editors. Risk communication and vaccination. Washington, DC: Institute of Medicine, National Academy Press, 1997Google Scholar
- 10.WHO. World health report: reducing risks, increasing healthy lives. Geneva: WHO, 2002Google Scholar
- 14.Yahya M. Polio vaccines — difficult to swallow: the story of a controversy in Northern Nigeria. IDS working paper 261 [online]. Available from URL: http://www.ids.ac.uk/files/Wp261.pdf [Accessed 2012 Apr 17]
- 19.WHO. EPI brief (February 2012). Geneva: WHO, 2012Google Scholar
- 20.WHO/UNICEF. Joint statement: global plan for reducing measles mortality 2006–2010 [online]. Available from URL: http://www.who.int [Accessed 2012 Mar 27]
- 21.Mnookin S. The panic virus. New York: Simon and Shuster, 2011Google Scholar
- 24.Betraying the public over nvCJD risk [editorial]. Lancet 1996; 348 (9041): 1529Google Scholar
- 25.UK Department of Health. NHS immunisation statistics, England: 1997–1998 (table 2) [online]. Available from URL: http://www.dh.gov.uk/en/Publicationsandstatistics/Statistics/StatisticalWorkAreas/Statisticalhealthcare/DH_4016221 [Accessed 2012 Mar 12]
- 26.UK Department of Health. NHS immunisation statistics, England: 2010–11. Immunisations received by first and second birthday [online]. Available from URL: http://www.ic.nhs.uk/statistics-and-data-collections/health-and-lifestyles/immunisation/nhs-immunisation-statistics-england-2010-11 [Accessed 2012 Mar 12]
- 34.Wakefield AJ. Callous disregard: autism and vaccines — the truth behind a tragedy [online]. Available from URL: http://www.callous-disregard.com/ [Accessed 2012 Apr 24]
- 39.Messenger S. Melanie’s marvellous measles. Australia: Nature Matters, 2010Google Scholar
- 43.CDC. Measles: United States, January–May 20, 2011. MMWR 2011; 60 (20): 666–8 [online]. Available from URL: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6020a7.htm?s_cid=mm6020a7_w [Accessed 2012 Mar 22]Google Scholar
- 44.WHO. Weekly epidemiological record. Progress in global measles control, 2000–2010 [online]. Available from URL: http://www.who.int/wer/2012/wer8705.pdf [Accessed 2012 Mar 27]
- 45.WHO. Weekly epidemiological record. Measles outbreaks and progress towards meeting measles pre-elimination goals: WHO African region, 2009–2010 [online]. Available from URL: http://www.who.int/wer/2011/wer8614.pdf [Accessed 2012 Mar 27]
- 46.WHO. Global elimination of measles: report by the Secretariat. WHO Executive Board, 125th Session; 2009 April 16. Report No:EB125/4 [online]. Available from URL: http://apps.who.int/gb/ebwha/pdf_files/EB125/B125_4-en.pdf [Accessed 2012 Aug 28]
- 47.Woonink F. Objections against vaccination: the perspective of those who refuse. National Institute for Public Health and the Environment, the Netherlands, 2009 [online]. Available from URL: http://www.rivm.nl [Accessed 2012 Sept 18]
- 48.CDC. Measles: United States, 2011. MMWR 2012; 61 (15): 253–7 [online]. Available from URL: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6115a1.htm#tab [Accessed 2012 Apr 21]Google Scholar
- 50.Waisbord S, Larson H. Why invest in communication for immunization? Evidence and lessons learned. A joint publication of the Health Communication Partnership, Johns Hopkins Bloomberg School of Public Health (Baltimore) and UNICEF (New York) [online]. Available from URL: http://www.globalhealthcommunication.org/tool_docs/21/why_invest_in_communication_for_immunization.pdf [Accessed 2012 Mar 27]