Despite the well-developed Chinese National Immunization Program, vaccine hesitancy in China is rising. As part of the response, Chinese scholars have studied determinants and proposed solutions to vaccination hesitancy. We performed a scoping review of Chinese literature (2007–2019), drawn from four Chinese databases. We mapped relevant information and presented a systemic account of the proposed determinants and responses to vaccine hesitancy in China. We identified 77 relevant studies that reveal four approaches to vaccine hesitancy. Most Chinese studies define vaccine hesitancy as a problem of vaccine safety and vaccine incident response and place accountability on the level of governance, such as regulation deficits and inappropriate crisis management. A first minority of studies tied vaccination hesitancy to unprofessional medical conduct and called for additional resources and enhanced physician qualifications. A second minority of studies positioned vaccination hesitancy as a problem of parental belief and pointed to the role of media, proposing enhanced communication and education. Chinese literature ties vaccine hesitancy primarily to vaccine safety and medical conduct. Compared to international research, parental concerns are underrepresented. The Chinese context of vaccination scandals notably frames the discussion of vaccination hesitancy and potential solutions, which stresses the importance of considering vaccination hesitancy in specific social and political contexts.

A series of vaccine incidents have stimulated vaccine hesitance in China over the last decade. Many scholars have studied the institutional management of these incidents, but a qualitative study of stakeholders’ perspectives on vaccine hesitancy in China is missing. To address this lacuna, we conducted in-depth interviews and collected online data to explore diverse stakeholders’ narratives on vaccine hesitance. Our analysis shows the different perspectives of medical experts, journalists, parents, and self-defined vaccination victims on vaccination and vaccination hesitance. Medical experts generally consider vaccines, despite some flaws, as safe, and they consider most vaccine safety incidents to be related to coupling symptoms, not to vaccinations. Some parents agree with medical experts, but most do not trust vaccine safety and do not want to put their children at risk. Media professionals, online medical experts, and doctors who do not need to align with the political goal of maintaining a high vaccination rate are less positive about vaccination and consider vaccine hesitance a failure of expert–lay communication in China. Our analysis exhibits the tensions of medical expert and lay perspectives on vaccine hesitance, and suggests that vaccination experts ‘see like a state’, which is a finding consistent with other studies that have identified the over-politicization of expert–lay communication in Chinese public discourse. Chinese parents need space to express their concerns so that vaccination programs can attune to them.

Incessant food safety scandals in China have given rise to a loss of public trust in food safety, stimulating a series of studies focussing on food safety governance, accountability, and trust restoration. Against this backdrop, Chinese scholars are keen to reflect on different strategies for ensuring food safety public accountability and credibility, presenting different perspectives on issues like responsibility, trust, risk communication, and transparency. In this paper, we aim to get more in-depth insight into how Chinese scholarly debates co-construct public accountability for food safety as a public issue. We selected 51 articles from 10,790 candidates drawn from four Chinese academic databases for content analysis. Drawing from political theories on public accountability as well as science and technology studies, the analysis shows that arguments for a specific public accountability model (more or less centralised, more or less stakeholder participation) are intertwined with the specific role of scientific expertise (more or less authoritative, more or less democratising). As such, the analysis shows how scholarly debates on public accountability for food safety in China co-construct a public forum for discussing supervision and accountability, risk assessment, and transparency.

No abstract

No abstract