The delicate situation of childhood vaccination: On the dispreferredness of soliciting parents’ intent to vaccinate

In the Netherlands, parents of newborns typically participate in two-, four-, and eight-week medical consultations
to monitor their children’s development and discuss vaccinations, which will not be administered before
eight weeks. During these visits, healthcare professionals routinely ask parents if they intend to vaccinate their
children (i.e. to participate in the National Immunization Program). Using Conversation Analysis, we examine 62
videotaped consultations and present two lines of evidence to argue that the sequence initiated by professionals
wherein they solicit parents’ intent to vaccinate is dispreferred. First, this action is routinely deferred by
preliminary sequences. Second, when professionals eventually initiate this action (i.e. if it is not preempted by
parents during pre-sequences), they orient to its dispreferred status, for example by highlighting benefactive
details of vaccination. We discuss the possible existence of asymmetrical (initiator-sided) pre-sequences, why
soliciting parents’ vaccination intent might be dispreferred, and implications for the design of communication
interventions.