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U of T researcher looks at 'hesitancy' to get vaccinated in Barbados

“I am not documenting why people are hesitant to the vaccine but that they’re hesitant, how they express it and what that means,” says U of T's Nicole Charles about the HPV vaccine (photo by Matthew Busch for The Washington Post via Getty Images

Nicole Charles remembers the qualms that arose when the human papillomavirus (HPV) vaccination first began to be administered to girls in Canada to protect against strains of a sexually transmitted virus that can cause cervical cancer.

Charles, then an undergraduate student, studied the immunization program and the reactions that parents had to it for a research paper that she wrote as she was completing her bachelor’s degree. The HPV vaccine would also become the focus of her master’s work, and it similarly was the topic of her PhD dissertation.

“It was a research question that emerged from a personal experience,” says Charles (pictured left), an assistant professor in the department of historical studies at U of T Mississauga. She has continued to study the HPV vaccine and the phenomenon of vaccine hesitancy by carrying out ethnographic research on ambivalence toward the HPV vaccine among parents in Barbados. The country has rolled out its own vaccination program over the last four years.

The findings are the topic of a book she is writing, Suspicion: Vaccines, Hesitancy and the Affective Politics of Protection in Barbados, which explores the complex issues surrounding resistance to the HPV vaccine in the Caribbean country.

“For me, it’s all about language,” says Charles, who came to U of T Mississauga last year. “I am not documenting why people are hesitant to the vaccine but that they’re hesitant, how they express it and what that means.”

Charles was born in Canada, grew up in Trinidad & Tobago and returned here for university. She says the “seedlings for this research topic were planted” when she saw that her own mother was “unable to articulate what was unnerving for her” about the HPV vaccination program back in 2006, when the vaccine was introduced. “She encouraged me to look closer into the vaccine and its merits and write one of my course research papers on the topic,” says Charles.

The subject would occupy Charles for the next dozen years. She chose Barbados as a field site for her current study because, in 2014, it was the most recent Caribbean country to introduce the HPV vaccine through a national program. “The topic was very much at the forefront of the citizenry’s consciousness.”

She says her research showed that Barbadian parents’ suspicions about the vaccine went beyond scientific ignorance or cultural taboos around sex. “Suspicion instead, I argue, is something more ambiguous and affective,” she says, based on feelings and emotions.

She notes that the issue has “multiple layers.” For example, the Anglophone Caribbean is shaped by the legacies of slavery and colonialism. At the same time, Barbados and much of the region has a disproportionately high burden of HPV, and some of the highest incidences of cervical cancer in the Americas. She says public health practitioners looking to tailor their messages and improve the vaccination rate “might more carefully rethink the ways in which technologies like the HPV vaccine are promoted, in light of the specificities and histories of the region.”

Charles says the goal of her research is to “bring issues of suspicion and refusal to light,” and it does not extend to vaccination hesitancy in general. “This conversation has to be had in specific locales in relation to specific vaccines.”

She’s currently in conversation with book publishers. Meanwhile, she’s working on a new project that looks at the cultural politics of race, sugar, food, diabetes and hypertension in post-colonial Barbados.