Interview With Folklorist Andrea Kitta: Vaccines, Public Health, Risk Perception

Being a folklorist means that whenever I chat with my colleagues, I find that they are researching really fascinating things. Take, for instance, Andrea Kitta, assistant professor of English at East Carolina University. She specializes in in medicine, belief, and the supernatural (and she’s a dancer, like me!). I knew that her book on vaccine rumors had just come out, so I asked if I could interview her for MySexProfessor, and fortunately, she agreed!

Jeana: How would you summarize the main ideas in your book for the general public?

Andrea: The main idea is that those who oppose or question vaccination are not crazy people who should automatically be dismissed. Those who oppose/question vaccination are capable of rational thought, have some very valid points, are good parents, and have a lot to offer the biomedical community. If nothing else, they are people who are actively involved in their own health care and take responsibility for their actions, which is something I think should be encouraged, especially in an age where the majority of our chronic health conditions are preventable.

THAT being said, it’s a study of the reasons why people do and do not receive their vaccines
from a multitude of perspectives, including patients, parents, grandparents, doctors, nurses,
chiropractors, nursing students, medical students, midwives, and other alternative health
professions. Basically, what I tried to do is understand what is the perceived risk and how do
people make decisions about vaccines? What affects these decisions?

Jeana: What drew you to the study of vaccinations and risk perception?

Andrea: I always knew I wanted to work on a topic that dealt with modern medical folklore – so many people think of herbal remedies or other “old timey” things when they hear folk medicine, not the more modern applications. I’ve always been fascinated with belief and how individuals process health information and concepts of risk, so I just started paying attention. What were health related issues I saw on the news and online? What were my friends and family discussing when it came to their own healthcare? Vaccines came up frequently and once I started noticing the vaccine debates, I couldn’t stop noticing them. There seemed to be such a divide between “pro-vaccinators” vs. “anti-vaccinators” and the debates were so heated that I couldn’t help but to wonder what was at stake and how the groups became so polarized.

Jeana: You mentioned in conversation that one of the topics you discuss in the book is the HPV vaccine. What specifically did you discover about public perception of it?

Andrea: Sadly, I didn’t get to discuss this as much as I would have liked to in the book, so thanks for giving me the opportunity! The HPV debate is really interesting because it links to ideas of morality – there were some groups claiming that the HPV vaccine would actually cause girls to become more promiscuous, which seemed to be a ridiculous idea to me, as if teenage girls were sitting around and thinking that they would have sex if only there wasn’t the possibility of maybe getting cancer someday. There was a recently medical study (Bednarczyk et al. 2012) that actually proved there was no correlation between the HPV vaccine and promiscuity.

There is also an outcry from women who are past the age (26) where they are vaccinating for
HPV. They want to know why they cannot get the vaccine as well, especially if they are willing
to pay for it. The reasoning is that they have likely already been exposed to the virus, so the
focus should be on getting women vaccinated before they are sexually active. This is problematic since it assumes a level of sexual activity, which can be offensive to some women since they may be virgins or have had a limited number of sexual partners. Also, the minimum age for HPV is 9 with the recommended age being 11-12 (CDC 2012) which some are saying is too young, while others are pointing out that it may be too late, especially in cases of abuse.

Unfortunately, all of this was complicated by an ad campaign called “Because I’m smart”
which showed young girls and women stating that they were getting the vaccine “because I’m
smart”, indicating that refusal of the vaccine was not smart. As you can imagine, people did not appreciate the implication that they were stupid for being cautious of a vaccine that had been recently introduced.

And yes, boys should be getting their HPV vaccines as well since they can be carriers, the CDC has an entire fact sheet on men and HPV here and on the vaccine recommendations for boys here. Sadly, there are still no tests for HPV in men.

Jeana: Are there other vaccine topics that relate to sexual health?

Andrea: Yes, the Hepatitis vaccines are sometimes thought to be unnecessary or can wait until the child is older, primarily because hepatitis is commonly (but not always) spread through sexual activity. Again, it’s still best to get the vaccines long before there’s any chance of sexual activity or other behavior that is deemed risky (such as IV drug use). Most children are given their first Hep B shot at birth.

Jeana: Have you observed a breakdown in communication between certain groups when it comes to public health, such as between doctors and patients, or corporations and the general public?

Andrea: Absolutely, there’s a real disconnect between the language used by scientists and others in medicine (including public health) and the lay public. The statistical and cautious language used in health may sound unsure to the public, especially phrases such as “more research is needed”. The public wants the medical community to give them an answer that is foolproof, unfortunately there are always exceptions – like the person who smokes their entire life and never gets cancer. We know that statistically there is a correlation between smoking and cancer, especially lung cancer, but we also know that one person who has broken all the rules and is healthy.

The “public good” vs. individual good can also be hard to understand and internalize.
Organizations such as Public Health are interested in the greater good, so some risk is
acceptable, as long as it is a small amount and the majority is protected. However, if your child is in the minority of those who are injured by a vaccine, it may be harder to see the issue of the great good. It’s a difference perception of risk and both points are valid. Negotiating and
communicating that can be quite difficult.

Jeana: Based on your studies, what would you advise the general public to do in order to educate themselves about vaccines and health risks?

Andrea: I would say to talk to a medical professional that you trust. In an ideal world, we would all have family doctors that we could talk to about this issue, but I realize that’s not always the case. So many people find their health information on the Internet these days and that can be a great resource, especially for those with chronic conditions. I would just urge people to seek out multiple sources and really look at who is behind those sources. Anyone can create a website, so consider the agenda of the creator. I always tell people to think about something they know a lot about and then Google it to see what kind of information is out there – they will find bad information and that will help give them some perspective.

Jeana: Do you feel that your perspective as a folklorist has specially positioned you to contribute to this area of research? If so, how?

Andrea: Absolutely, in the past much of this research was done in a context of condemnation as a way of correcting behavior and forcing compliance, in some cases no one even bothered to ask people about their concerns! The populist approach of folkloristics has been crucial to this study, especially since in the case of risk, which is difficult to understand without the use of ethnography. I think the interdisciplinary nature of folklore has also positioned this research
in a different light since I was able to pull from a multitude of sources. When I’ve gone to
immunization conferences, people constantly tell me how innovative this approach is to the study of vaccines, however, most of these “innovations” are fundamental to the study of folklore.

Jeana: What else would you like to say on this topic? Is there anything I haven’t asked you about that you’d like to share with our readers?

Andrea: Just that I’m sorry the book is so expensive. Ask your library to buy it! If enough copies are sold it will go to paperback and we’re really close to that number!

Works Cited:

Bednarczyk, Robert A., Robert Davis, Kevin Ault, Walter Orenstein and Saad B. Omer.
2012. “Sexual Activity-Related Outcomes After Human Papillomavirus Vaccination of 11- to
12-Year-Olds” Pediatrics 130;798-805. Originally published online October 15, 2012. Accessed
November 20, 2012.

CDC. 2012. “Recommended and Minimum Ages and Intervals Between Doses” http://
www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/a/age-interval-table.pdf. Accessed
November 20, 2012.

About Jeana

Jeana

Jeana Jorgensen, PhD recently completed her doctoral degree in folklore and gender studies at Indiana University. She studies fairy tales and other narratives, dance, body art, feminist theory, digital humanities, and gender identity.