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Public health programs facilitate access to resources that not only provide individuals’ options but also often foreclose individual preference through prescriptive requirements. This chapter takes two disparate cases from public health – vaccines and family planning –that reveal patterns of inequality in who has access to individual choice and who requires state support to exercise choice. Looking specifically at dynamics of funding and compulsion, this chapter elucidates how reliance on the rhetoric of individual choice as an expression of freedom rewards those with the greatest access to resources and fails to make sure that all members of the community have the resources to shape their own outcomes or to make sure collective health is protected.

The COVID-19 pandemic was unprecedented and has disproportionately affected the lives and livelihoods of people worldwide. Many governments restricted social and economic activities to curb the virus, and with the availability of the COVID-19 vaccine, many see it as providing hope to return to normalcy. Within such a context, China, Russia, and the United States (USA) have leveraged their vaccine diplomacy to gain and expand their influence. Vaccine diplomacy could help major powers cement their influence well beyond the pandemic if successfully deployed. By examining the vaccine diplomacy race in Southeast Asia, this chapter reveals the factors that motivate major powers to engage in the race and the strategies used. This chapter also assesses China’s vaccine diplomacy in Malaysia and how it has contributed to cementing a stronger bilateral relationship between Malaysia and China that would probably outlast the pandemic.

Much of the discussion surrounding the antivaccine movement focuses on the decision of parents to not vaccinate their children and the resulting danger posed to others. However, the primary risk is borne by the child left unvaccinated. Although living in a developed country with high vaccination rates provides a certain amount of protection through population immunity, the unvaccinated child is still exposed to a considerably greater risk of preventable diseases than one who is vaccinated. I explore the tension between parental choice and the child’s right to be free of preventable diseases. The chapter’s goal is twofold: to advocate for moving from a dyadic framework – considering the interests of the parents against those of the state – to a triadic one, in which the interests of the child are given as much weight as those of the parent and the state; and to discuss which protections are available, and how they can be improved. Specific legal tools available to protect that child are examined, including tort liability of the parents to the child, whether and to what degree criminal law has a role, under what circumstances parental choice should be overridden, and the role of school immunization requirements in protecting the individual child.

This chapter argues that neoliberal governmentality in immunization relocates the Turkish state's position regarding vaccine and immunization policies. Neoliberalism is often discussed in the context of privatization, performance, and effectiveness separately. However, more attention should be paid to the set of strategies that are employed in public policy processes to manage populations in terms of immunization, while intertwining power with knowledge. Following Foucault's concept of governmentality and taking it further within the context of biopolitics, this chapter focuses on different knowledge practices regarding vaccine and immunization policies in Turkey. In doing so, this case study applies a post-structural analysis to examine vaccine production, vaccine know-how, and immunization policies inscribed in policy documents as a form of knowledge practice. The analysis sheds light on the reflexive transformation of the concept of biopolitics, which is moving from state-oriented knowledge practices toward a neoliberal governmentality of immunization.

Researchers continue to seek understanding of industrialization as a state managed process. How to create and implement new industries based on advanced knowledge is on the policy agenda of many advanced nations. Measures that promote these developments include national capacity building in science and technology, the formation of technology transfer systems, and the establishment of industrial clusters. What these templates often overlook is an analysis of use. This chapter aims to increase the understanding of the processes that embed new solutions in structures from an industrial network perspective. The chapter describes an empirical study of high-technology industrialization in Taiwan that the researcher conducts to this end. The study shows that the Taiwanese industrial model is oversimplified and omits several important factors in the development of new industries. This study bases its findings on the notions that resource combination occurs in different time and space, the new always builds on existing resource structures, and the users are important as active participants in development processes.

The purpose of this research is to investigate how parents and caregivers describe their concerns about the HPV vaccine for their children on open Internet websites. The study examines what the discourse among parents reveals about their concerns regarding the HPV vaccine.

Our exploratory study utilized a grounded theory approach as a method of collecting data and simultaneously formulating research questions based on emerging themes from the data. We used purposeful sampling to select sets of comments posted on websites that provided news, scientific information, or parental support regarding HPV and its vaccine.

Findings suggest support for Bond and Nolan’s (2011) theory that familiarity with a disease is central to parents’ assessment of risk, and that dread of a serious disease such as cervical cancer is weaker than dread of unknown possible side effects in parents’ motivation to give or withhold the vaccine for their children.

Research limitations include our usage of a purposeful convenience sample of websites. The limitation of this sampling technique is that the comments made by website “users” and used in the analysis may not be representative of the wider population, and may include Americans as well as non-Americans.

Our research fills an important gap in the literature by looking at the ways in which parents share their concerns about the HPV vaccine on Internet websites as they consider whether to reject, delay, or consent to the vaccine.

To measure adolescent girls’ preferences over features of human papillomavirus (HPV) vaccines in order to provide quantitative estimates of the perceived benefits of vaccination and potential vaccine uptake.

A discrete choice experiment (DCE) survey was developed to measure adolescent girls’ preferences over features of HPV vaccines. The survey was fielded to a U.S. sample of 307 girls aged 13–17 years who had not yet received an HPV vaccine in June 2008.

In a latent class logit model, two distinct groups were identified – one with strong preferences against vaccination which largely did not differentiate between vaccine features, and another that was receptive to vaccination and had well-defined preferences over vaccine features. Based on the mean estimates over the entire sample, we estimate that girls’ valuation of bivalent and quadrivalent HPV vaccines ranged between $400 and $460 in 2008, measured as willingness-to-pay (WTP). The additional value of genital warts protection was $145, although cervical cancer efficacy was the most preferred feature. We estimate maximum uptake of 54–65%, close to the 53% reported for one dose in 2011 surveillance data, but higher than the 35% for three doses in surveillance data.

We conclude that adolescent girls do form clear opinions and some place significant value on HPV vaccination, making research on their preferences vital to understanding the determinants of HPV vaccine demand.

DCE studies may be used to design more effective vaccine-promotion programs and for reassessing public health recommendations and guidelines as new vaccines are made available.

Though it is one of the strongest predictors of vaccine initiation, few studies have examined the social correlates of health care professional (HCP) recommendations of the human papillomavirus (HPV) vaccination. This study employs a “fundamental causes” framework to examine whether family socioeconomic status is associated with parent reports of HPV vaccine uptake and HCP recommendation of the vaccine among female youth aged 12–17.

Using the 2007 National Survey of Children’s Health, a nationally representative sample of parents in the United States, this study documents a clear socioeconomic gradient in HCP recommendation of the HPV vaccine.

Results from a set of logistic regression models demonstrate that lower income families have significantly lower odds of vaccine initiation; however, the effect of household income is mediated by HCP recommendation. Further analyses reveal that lower income and poor families have reduced odds of receiving a HCP recommendation even when other health care related factors such as insurance status, annual preventive care, and a usual source of care are controlled.

The findings suggest that low income and poor families are less likely to receive needed health information regarding the HPV vaccine, thereby reducing the likelihood of vaccine uptake.

Across the United States (US), COVID-19 vaccination coverage was lower in rural counties compared to urban counties, exacerbating rural health inequities. While rural communities fall short of the public health goal to vaccinate all who are eligible, most rural residents have chosen to vaccinate for COVID-19. The aim of this study was to better understand rural New Mexicans' attitudes and beliefs about COVID-19 vaccines.

We conducted and analyzed 51 in-depth, semi-structured interviews with adults living in rural New Mexican counties, covering a range of topics related to the pandemic, including vaccines. These interviews were conducted in the Summer of 2021 after the vaccines were widely available to all adults over the age of 18 and youth between the ages of 12–17, but not yet available for children under 12 years.

Two major perspectives were identified: (1) the idea that COVID-19 vaccinations are a tool that individuals can use to achieve freedom and protection and (2) the view which regarded vaccines as an infringement of personal rights and one's autonomy of health. For people who viewed the vaccine as a tool for freedom, several themes emerged, including (1) a preference for vaccine manufacturers, specifically a preference for Pfizer, and (2) frustrations related to vaccine access, specifically, older adults expressed frustrations with the difficulty of scheduling vaccination appointments. However, most participants felt as though they had enough vaccination resources. For people who viewed vaccines (and vaccine mandates) as limiting their freedom, additional themes emerged: (1) overarching distrust of government and the perception that vaccines were an extension of government and (2) distrust in the vaccines themselves, including a perceived lack of research on the vaccines and a perception that the vaccine was developed in too short of a period. Some of the people who hold these beliefs are also vaccinated. We draw from social psychology theories to better understand how people who hold a rural identity come to establish different beliefs and practices compared to larger metropolitan regions. While political identity is a contributor, of our participants, the group who were most likely to report not being vaccinated were the “independent” or “unaffiliated voters.” Our findings can help craft culturally responsive vaccine initiatives for rural communities.