“Stick without a Carrot”: An Anthropological Analysis of the Daily Press on Mandatory MMR Immunization in Serbia

Authors

  • Marija Brujić Institute of Ethnology and Anthropology, Faculty of Philosophy, University of Belgrade, Serbia

DOI:

https://doi.org/10.21301/eap.v15i4.2

Keywords:

MMR vaccination, the Republic of Serbia, measles epidemics 2014-15 and 2017-18, daily press

Abstract

The vaccine is considered in academic, foremost medical, but also in political and public discourse as one of the greatest human achievements. Immunization has saved and is saving millions of lives around the world. However, from a historical perspective, immunization was always followed by more or less public resistance due to its alleged negative side-effects, such as outbursts of severe illnesses. A mandatory childhood vaccine against measles, mumps, and rubella (MMR) is part of the current controversy over the harmfulness of vaccines in Serbia. In view of the fact that the media is an important source for transmitting health messages and understanding health issues, the subject of this paper is the media presentation of MMR immunization in Serbia. How was the state health care narrative on MMR immunization presented in the Serbian daily press during the last two measles outbreaks in 2014-2015 and 2017-2018? By using the theoretical “text-context-hypertext” approcah to media content by Ljiljana Gavrilović, Serbian broadsheets and daily papers, such as Blic, Kurir, Politika, Večernje Novosti, from the period 2014-2020, are analyzed. The preliminary results show that the news that concurs with the 2014-15 measles epidemic differs greatly from the news during the 2017-18 epidemic. During the first period, the papers carried medical experts’ advice on the benefits and importance of the MMR vaccine, criticizing (irrational and emotional) parents (mostly mothers) who do not vaccinate their children, in parallel with parental lay evidence on its harmfulness. From approximately 2017 anti-vaccination attitudes disappeared from the newspapers, even from the yellow press. This is concomitant with the new Law on the Protection of the Population against Communicable Diseases (2016), which penalizes anti-vaccination lobbying. In other words, instead of gaining public trust in the health sector and the state by presenting facts, offering dialogue with opponents and systematic education, the state leaders discredited and excluded opposing opinions as “uncivilized”, “irrational” and part of “anti-vaccination lobbying”. Studies explained that citizens of post-socialist countries trust more individuals (friends and family) and distrust the state authorities (as enemies). By introducing compulsory penalties for non-vaccination, the state only deepened this historical and cultural distrust between the state and its citizen. To conclude, insults to parents of non-immunized children, threats of penalties and actual penalties, and the exaggeration of the outcomes of the 2014-15 measles epidemic did not lead to mass immunization. On the contrary, all this acted only counterproductively, as the latest epidemic broke out precisely among non-vaccinated and semi-vaccinated populations. Therefore, it is suggested in the paper that this vaccine should be optional, parallel with the introduction of organized promotion of MMR vaccination, its benefits and side-effects, detailed information on vaccine content, greater freedom of media content on the MMR vaccine, and open public dialogue of parents with medical experts.

Downloads

Download data is not yet available.

References

Agencija za lekove i medicinska sredstva Srbije [ALIMS]. 2019. Godišnji izveštaj o prijavljivanju neželjenih reakcija na lekove u Republici Srbiji 2018. Beograd: Nacionalni centar za farmakovigilancu NCF. https://www.alims.gov.rs/ciril/files/2019/07/Godisnji-izvestaj-o-prijavljivanju-NRL-2018.pdf [15 maj 2020]

Atkin, Charles. 2001. Impact of Public Service Advertising: Research Evidence and Effective Strategies. Kaiser Family Foundation, 1-47. https://www.yumpu.com/en/document/read/7268393/impact-of-public-service-advertising-research-evidence-and- [8 maj 2020]

Blume, Stuart. 2006. “Anti-Vaccination Movements and Their Interpretations.” Social Science and Medicine 62: 628–642. DOI 10.1016/j.socscimed.2005.06.020

Bond, Lyndal and Terry Nolan. 2011. “Making Sense of Perceptions of Risk of Diseases and Vaccinations: A Qualitative Study Combining Models of Health Beliefs, Decision-Making and Risk Perception.” BMC Public Health 11 (943): 1-14. 0.1186/1471-2458-11-943.

British Medical Journal (BMJ). 1994. “Families Win Support for Vaccine Compensation Claim.” British Medical Journal 309 (6957): 759.

Deer, Brian. 2011. “How the Case Against the MMR Vaccine Was Fixed.” British Medical Journal 342: 77-82.

Draškić, Marija. 2018. „Obavezna vakcinacija dece: pravo pacijenata ili interes javnog zdravlja?“ Anali Pravnog fakulteta u Beogradu LXVI (3): 7-30.

Đurić-Petković Danica, Elizabeta Ristanović i Nada Kuljić-Kapulica. 2017. „Virus malih boginja.” Medical Data 9 (3): 181-184.

Evans, Maggie, Helen Stoddart, Louise Condon, Elaine Freeman, Marg Grizzell and Rebecca Mullen. 2001. “Parents’ Perspectives on the MMR Immunisation: A Focus Group Study.” British Journal of General Practice 51: 904-910.

Gavrilović, Ljiljana. 2005. „Preludijum za antropologiju medija.“ U Etnologija i antropologija: stanje i perspektive. Zbornik Etnogarfskog instituta SANU 21, uredila Dragana Radojičić, 143-150. Beograd: Etnografski institut.

Hamilton Matilda, Paul Corwin, Suzanne Gower and Sue Rogers. 2004. “Why Do Parents Choose not to Immunise Their Children?” The New Zealand Medical Journal 117 (1189): 1-6.

Ilić, Dragan, Dragana Dimitrijević, Mitra Drakulović et al. Izveštaj o zaraznim bolestima u Republici Srbiji za 2015. godinu. Beograd: Institut za javno zdravlje Srbije “Dr Milan Jovanović Batut“. http://www.batut.org.rs/download/izvestaji/Zarazne%20bolesti%20godisnji%20izvestaj%202015.pdf [26 apr 2020]

Kata, Anna. 2010. “A Postmodern Pandora’s Box: Anti-Vaccination Misinformation on the Internet.” Vaccine 28: 1709–1716. DOI 10.1016/j.vaccine.2009.12.022

Kareklas, Ioannis, Darrel D. Muehling, and T.J. Weber. 2015. “Reexamining Health Messages in the Digital Age: A Fresh Look at Source Credibility Effects.” Journal of Advertising 44 (2): 88–104. DOI 10.1080/00913367.2015.1018461

Knežević, Srebrica. 1989. „Velike boginje (variola vera). Rezultanta odnosa narodnog običajnog života i njegove zdravstvene kulture“. Acta historica medicinae, pharmacie, veterinae 29 (2): 55-82.

Knežević, B. Snežana, Ljiljana P. Đurović, Vladan D Šaponjić, Verica D. Đukić i Nadica P. Radonjić. 2019. „Epidemija malih boginja u Kraljevu, Srbija, 2017/2018.“ Оpšta medicina 25 (3-4):81-94.

Leask, Julie and Peter McIntyre. 2003. “Public Opponents of Vaccination: a Case Study.” Vaccine 21: 4700-4703. DOI 10.1016/S0264-410X(03)00520-6

Miller, Elizabeth. 2002. “MMR Vaccine: Review of Benefits and Risks. Review.“ Journal of Infection No. 44, 1-6.

Moore, Alfred and Jack Stilgoe. 2009. “Experts and Anecdotes: The Role of ‘Anecdotal Evidence’ in Public Scientific Controversies.” Science, Technology, & Human Values 34 (5): 654-677. DOI 10.1177/0162243908329382

Mujović-Zornić, Hajrija. 2016. „Odgovornost za štetu od vakcina.” Pravni život. Časopis za pravnu teoriju i praksu I (9): 303-320.

Murch, Simon, Mike Thomson and John Walker-Smith. 1998. “Author's Reply.” The Lancet 351 (9106): 908.

O’Brien, J. Sarah, Ian G. Jones and Peter Christie. 1998. “The Correspondence. Autism, Inflammatory Bowel Desealse, and MMR Vaccine.” The Lancet 351 (9106): 906.

Pareek, Manish and Helen Pattison. 2000. “The Two-Dose Measles, Mumps, and Rubella (MMR) Immunisation Schedule: Factors Affecting Maternal Intention to Vaccinate.” British Journal of General Practice 50: 969-971.

Payne, Christopher and Brendan Mason. 1998. “The Correspondence. Autism, Inflammatory Bowel Disease, and MMR Vaccine.” The Lancet 351 (9106): 907.

Petrović, Vladimir. 2018. Epidemija malih boginja u Republici Srbiji 2017/18 godine. http://cji.com.hr/wp-content/uploads/2018/05/1.Epidemija-malih-boginja-u-Srbiji-2017-18-godine_Vladimir-Petrovi%C4%87.pdf [26 apr 2020]

Petts, Judith and Simon Niemeyer. 2004. “Health Risk Communication and Amplification: Learning from the MMR Vaccination Controversy.” Health, Risk & Society 6 (1): 7-23. DOI 10.1080/13698570410001678284

Poltorak, Mike, Melissa Leach and James Fairhead. 2004. MMR “Choices” in Brighton: Understanding Public Engagement with Vaccination Science and Delivery. IDS Working Paper 224. Brighton: Institute of Development Studies.

Prior, Lindsay. 2003. “Belief, Knowledge and Expertise: The Emergence of the Lay Expert in Medical Sociology.” Sociology of Health & Illness 25: 41–57. DOI 10.1111/1467-9566.00339

Radovanović, Zoran. 2016. Istina o vakcinama. Priručnik za savesne roditelje. Smederevo: Heliks.

Rot, Klaus. 2012. Od socijalizma do Evropske unije. Ogledi o svakodnevnom životuu jugoistočnoj Evropi. Beograd: Biblioteka XX vek.

Serpell, Lucy and John Green. 2006. “Parental Decision-Making in Childhood Vaccination.” Vaccine 24 (19): 1-6.

Sjeničić, Marta, Dragana Miljuš i Marko Milenković. 2016. „Nacionalni pravni okvir kojim se uređuje oblast zaštite stanovništva od zaraznih bolesti.“ Pravni život. Časopis za pravnu teoriju i praksu I (9): 321-337.

Streefland, Pieter, A.M.R. Chowdhury and Pilar Ramos-Jimenez. 1999. “Patterns of Vaccination Acceptance.” Social Science & Medicine 49: 1705-1716.

Streefland, Pieter H. 2001. “Public Doubts about Vaccination Safety and Resistance against Vaccination.” Health Policy 55: 159–172.

Taylor, Brent, Elizabeth Miller, C. Paddy Farrington, Maria-Christina Petropoulos, Isabelle Favot-Mayaud, Jun Li, and Pauline A. Waight. 1999. “Autism and Measles, Mumps, and Rubella Vaccine: No Epidemiological Evidence for a Causal Association“. Lancet 353: 2026–2029.

Trifunović, Vesna. 2017. “Temporality and Discontinuity as Aspects of Smallpox Outbreak in Yugoslavia.” Glasnik Etnografskog institute SANU LXV (1): 127-145. DOI 10.2298/GEI1701127T

Trifunović, Vesna. 2019. “Framing Vaccination in Post-Socialist Serbia: An Anthropological Perspective.” Etnoantropološki problemi 14 (2): 507-529. https://doi.org10.21301/eap.v14i2.5

Žikić, Bojan. 2013. Slike u izlogu. Kulturne predstave o Evropskoj uniji kao sredstvo opisivanja paralelne stvarnosti stanju u Srbiji 1991-2011. Beograd: Srpski genealoški centar i Odeljenje za etnologiju i antropologiju Filozofskog fakulteta.

Закони

Ćirić, Jovan ur. 2019. „Bilten Ustavnog suda za 2017. godinu.“ Beograd: Ustavni sud, Službeni glasnik RS. http://www.ustavni.sud.rs/Storage/Global/Documents/Sudska_Praksa/Билтен_2017.pdf [12 maj 2020]

Pravilnik o programu obavezne i preporučene imunizacije stanovništva protiv određenih zaraznih bolesti. 2020. Službeni glasnik RS 65. https://www.paragraf.rs/propisi/pravilnik-o-programu-obavezne-i-preporucene-imunizacije-stanovnistva-protiv-odredjenih-zaraznih-bolesti.html [12 maj 2020]

Savet Evrope. 2010. Konvencija o ljudskim pravima. 2010. Strazbur: Evropski sud za ljudska prava. https://www.echr.coe.int/Documents/Convention_SRP.pdf [13 maj 2020]

Ujedinjene nacije. 1948. Univerzalna deklaracija o ljudskim pravima. https://www.poverenik.rs/images/stories/Dokumentacija/54_ldok.pdf [10 maj 2020]

United Nations. 1990. Convention on the Rights of the Child.

Ustav Republike Srbije. 2006. Službeni glasnik 98.

Zakon o potvrđivanju Konvencije o zaštiti ljudskih prava i dostojanstva ljudskog bića u pogledu primene biologije i medicine: Konvencija o ljudskim pravima i biomedicini. 2010. Službeni glasnik RS - Međunarodni ugovori 12. http://ravnopravnost.gov.rs/wp-content/uploads/2012/11/images_files_Konvencija%20o%20ljudskim%20pravima%20i%20biomedicini.pdf [13 maj 2020]

Zakon o osnovnom obrazovanju i vaspitanju. 2013, 2017 i 2018. Službeni glasnik RS 55/13; 101/17; 27/18.

Zakon o pravima pacijenata. 2013. Službeni glasnik RS 45.

Zakon o predškolskom vaspitanju i obrazovanju. 2010, 2017, 2018 i 2019. Službeni glasnik RS 18/10; 101/17; 113/17; 95/2018; 10/19.

Zakon o zaštiti stanovništva od zaraznih bolesti. 2016. Službeni glasnik RS 15.

Zakon o finansijskoj podršci porodici sa decom. 2017 i 2018. Službeni glasnik RS 113/2017 i 50/2018.

Извори

Alo. 2014. „MMR vakcina ipak izaziva autizam?!“ Alo [online], 08. februar. http://arhiva.alo.rs/vesti/aktuelno/mmr-vakcina-ipak-izaziva-autizam/45735 [09 apr 2016]

Alo. 2015. „Nemam ni za vakcinu, odakle mi za kaznu?“ Alo[ online], 30. januar. http://arhiva.alo.rs/vesti/aktuelno/nemam-ni-za-vakcinu-odakle-mi-za-kaznu/83909 [29 nov 2015]

B92. 2020. Novi Pravilnik o imunizaciji: Evo za koga je vakcina obavezna i kolike su kazne. https://www.b92.net/zdravlje/vesti.php?yyyy=2020&mm=05&dd=11&nav_id=1682945 [13 maj 2020]

Blic. 2015. „Nećete da vakcinišete dete? Platićete 50.000!“ Blic [online], 24. januar. http://www.blic.rs/vesti/drustvo/necete-da-vakcinisete-dete-platicete-50000/0ddzb40 [09 apr 2016]

Blic. 2016а. „Skandal skrivan 30 godina. Loša vakcina uništila život 15 mališana.“ Blic [online], 2. februar. http://www.blic.rs/vesti/drustvo/skandal-skrivan-30-godina-losa-vakcina-unistila-zivot-15-malisana/s279cf1 [20 apr 2016]

Blic. 2016b. „Obavezna vakcinacija. Šta vas čeka ako nećete vakcinu, a šta vas zbunjuje.“ Blic [online], 17. april. http://www.blic.rs/vesti/drustvo/obavezna-vakcinacija-sta-vas-ceka-ako-necete-vakcinu-a-sta-vas-zbunjuje/6738403 [15 apr 2016]

Blic. 2016c. „Ko ne vakciniše dete, piše izjavu i ide pred inspekciju.“ Blic [online], 18. april. http://www.blic.rs/vesti/drustvo/ko-ne-vakcinise-dete-pise-izjavu-i-ide-pred-inspekciju/cqnjdtp [15 apr 2016]

Blic. 2017a. “Afera ‘Citostatici’. Pravosnažno oslobođeno svih troje optuženih lekara.” Blic [online], 29. jun. https://www.blic.rs/vesti/hronika/afera-citostatici-pravosnazno-oslobodeno-svih-troje-optuzenih-lekara/eelmyke [10 maj 2020]

Blic. 2017b. „Roditelji i lekari prijavili šarlatane: pala prva krivična prijava zbog širenja panike od vakcine.“ Blic [online], 25. novembar. https://www.blic.rs/vesti/drustvo/roditelji-i-lekari-prijavili-sarlatane-pala-prva-krivicna-prijava-zbog-sirenja-panike/7kzsvtv [ 21 apr 2020]

Blic. 2018a. „'Idi kući, rađaćeš još'. Potresne ispovesti roditelja koji sumnjaju da su im deca ukradena u porodilištu.“ Blic [online], 12. februar. https://www.blic.rs/vesti/drustvo/idi-kuci-radjaces-jos-potresne-ispovesti-roditelja-koji-sumnjaju-da-su-im-deca/ls1hl1f [14 maj 2020]

Blic. 2018b. „Više novca, stroža pravila. Ko ne vakciniše dete neće dobiti roditeljski dodatak, ali to nije jedino ograničenje.“ Blic [online], 19. jun. https://www.blic.rs/vesti/drustvo/vise-novca-stroza-pravila-ko-ne-vakcinise-dete-nece-dobiti-roditeljski-dodatak-ali-to/6d4sxcf [05 mar 2019]

Blic. 2019a. „Sin bahatog rektora prima doktorsku platu od 95.000 mesečno, i to bez diploma.” Blic [online], 3. jul. https://www.blic.rs/vesti/drustvo/sin-bahatog-rektora-prima-doktorsku-platu-od-95000-mesecno-i-to-bez-diplome/ym46khz [10 maj]

Blic. 2019b. „'Govedo!', 'bagro!' Besna rulja udarala lekare. Skandal na oduzimanju licence antivakcinašici Jovani Stojković i još jedna šarada u nizu.“ Blic [online], 26. decembar. https://www.blic.rs/vesti/drustvo/govedobagro-besna-rulja-udarala-lekare-skandal-na-oduzimanju-licence-antivakcinasici/x3bbqwc [10 maj 2020]

Danas. 2020. Počela Druga sednica Narodne skupštine za vreme vanrednog stanja. Danas [online], 6. maj. https://www.danas.rs/politika/pocela-druga-sednica-narodne-skupstine-za-vreme-vanrednog-stanja/ [13 maj 2020]

European Forum for Vaccine Vigilance [EFVV]. 2020. “About Us.” https://www.efvv.eu [16 May 2020]

Institut za javno zdravlje Srbije “Dr Milan Jovanović Batut” [Batut]. 2016. „Rezultati sprovedene imunizacije u Srbiji u period 2011-2015. godine.“ http://www.batut.org.rs/download/aktuelno/2016JulImunizacija.pdf [21 apr 2020]

Institut za javno zdravlje Srbije "Dr Milan Jovanović Batut” [Batut]. 2019. „Aktuelna epidemiološka sitaucija malih boginja (morbila) u Republici Srbiji.“ http://www.batut.org.rs/index.php?content=1629 [21 apr 2020]

Kurir. 2016a. „Ministra optužili da je ubio za Zemunce: ko 10 godina štiti Zlatibora Lončara?“ Kurir [online], 22. januar. https://www.kurir.rs/vesti/politika/2106113/ministra-optuzili-da-je-ubio-za-zemunce-ko-10-godina-stiti-zlatibora-loncara [10 maj 2020]

Kurir. 2016b. „Zastrašujuće: Vakcine su opasne po život i zdravlje.“ Kurir, 14. mart, 2-3.

Kurir. 2016c. „Pažnja! Vakcinu sme da primi samo skroz zdravo dete: potrebni detaljni pregledi!“ Kurir [online], 14. mart. http://www.kurir.rs/vesti/drustvo/paznja-vakcinu-sme-da-primi-samo-skroz-zdravo-dete-potrebni-detaljni-pregledi-citajte-u-kuriru-clanak-2173695 [09 apr 2016]

Kurir. 2016d. „Pedijatri su najvažnija karika u vakcinaciji!“ Kurir, 17. mart, 9.

Kurir. 2016e. „Afera vakcine. Potresna ispovest roditelja: Naše dete je umrlo, drugo nećemo da vakcinišemo!“ Kurir [online], 17. mart. http://www.kurir.rs/vesti/drustvo/afera-vakcine-potresna-ispovest-roditelja-nase-dete-je-umrlo-drugo-necemo-da-vakcinisemo-clanak-2175329 [20 mar 2016]

Kurir. 2017. „Umesto da budu iskorenje, male boginje se šire Srbijom: i to sve zbog jednog lobija...“ Kurir [online], 10. novembar. http://www.kurir.rs/vesti/drustvo/2939005/umesto-da-budu-iskorenje-male-boginje-se-sire-srbijom-i-to-sve-zbog-jednog-lobija [21 apr 2020]

Politika. 2011. „Afera 'vakcine': ispitan i Tomica Milosavljević.“ Politika [online], 5. avgust. http://www.politika.rs/scc/clanak/186758/Afera-vakcine-ispitan-i-Tomica-Milosavljevic [10 maj 2020]

Politika. 2015a. „Pametni roditelji (ne)vakcinišu svoju.“ Politika, 9. januar, 25.

Politika. 2015b. „Male boginje sve veća opasnost.“ Politika, 9. januar, 07.

Politika. 2016a. „Opasne tabloidne izmišljotine o vakcinama.“ Politika, 18. mart, 08.

Politika. 2016b. Mali narodi u raljama velikog poretka. Politika, 20. mart, 14-15.

Politika. 2016c. „Za aferu “vakcine” nema dokaza.“ Politika [online], 6. decembar. http://www.politika.rs/scc/clanak/369466/Za-aferu-vakcine-nema-dokaza [1 maj 2020]

Politika. 2017. „MMR vakcina nije uzrok autizma.“ Politika [online], 2. decembar. http://www.politika.rs/scc/clanak/393686/MMR-vakcina-nije-uzrok-autizma [21 apr 2021]

Politika. 2018a. „Male boginje prete mnogima.“ Politka [online], 21. januar. http://www.politika.rs/scc/clanak/396960/Male-boginje-pretnja-mnogima [21 apr 2020]

Politika. 2018b. „Minimalne kazne za nevakcinisanje dece.“ Politika [online], 4. april. http://www.politika.rs/scc/clanak/401407/Minimalne-kazne-za-nevakcinisanje-dece [21 apr 2020]

Politika. 2018c. „Registar dece sa razvojnim smetnjama biće gotov za godinu dana.“ Politika [online], 29. novembar. http://www.politika.rs/scc/clanak/416929/Registar-dece-sa-razvojnim-smetnjama-bice-gotov-za-godinu-dana [23 apr 2020]

Politika. 2019b. Oduzimanje dece samo u ekstremnim slučajevima. Politika, 14. аpril, 12-13.

Politika. 2019a. Uglavnom minimalne novčane kazne. Politika, 14. аpril, 12.

Politika. 2020a. Virus korona nije kolega ni kuga. Politika, 15. mart, 07.

Politika. 2020b. „Novi pravilnik o vakcinaciji počinje da važi tek 2021. godine. Politika [online], 14. maj. http://www.politika.rs/scc/clanak/454144/Novi-pravilnik-o-vakcinaciji-pocinje-da-vazi-tek-2021-godine [17 maj 2020]

Večernje novosti. 2015. „Vakcina ruski rulet? Porodica iz Sivca tvrdi: Sin nam izgubio govor zbog MMR-a!“ Večenje novosti [online], 13. oktobar. http://www.novosti.rs/vesti/srbija.73.html:571666-Porodica-iz-Sivca-tvrdi-Sin-nam-izgubio-govor-zbog-MMR-a [13 dec 2015]

Večernje novosti. 2017. „Uprkos antivakcionom lobiju: opet poverenje u MMR.“ Večernje novosti [online], 8. decembar. https://www.novosti.rs/vesti/naslovna/drustvo/aktuelno.290.html:699920-Opet-poverenje-u-MMR [21 apr 2020]

Downloads

Published

2020-12-03

How to Cite

Brujić , Marija. 2020. “‘Stick Without a Carrot’: An Anthropological Analysis of the Daily Press on Mandatory MMR Immunization in Serbia”. Etnoantropološki Problemi / Issues in Ethnology and Anthropology 15 (4):979–1006. https://doi.org/10.21301/eap.v15i4.2.