KNOW-VACC: Knowledge production and governance in vaccination policy

Rapid advances in the life sciences have made groundbreaking new vaccines possible, but also pose new challenges for policymaking. On the one hand, vaccination policy aims at protecting an established, costly public health program to ensure a continuously high uptake of vaccines against infectious diseases, such as measles, particularly against the backdrop of public skepticism or what is commonly referred to as vaccine hesitancy. On the other hand, and at times in conflict with the former, immunization programs are regularly expanded when new vaccines are introduced, for example, the new vaccine against the sexually transmitted Human Papilloma Virus (HPV), which may cause cancer. Such moments can lead to intense politicization of immunization programs (Paul 2016). Therefore, policymakers try to carefully balance these oft-conflicting aims. In doing so, studying immunizations, their effectiveness, but also the perception of particular target groups become a central component of national immunization programs. The proposed study considers the different ways in which such data is gathered in two country-based case studies, Austria and The Netherlands. Drawing on concepts and methods from political science and science and technology studies (STS), the project employs desk research, literature review, and expert interviews (n=40+) to investigate the design, use, and potential future use of so- called vaccination registries. We understand these databases to form central infrastructures in shaping immunization policy, much like railways are in shaping other policy areas. We hypothesize that these registries can generate new knowledge but also shape relations between the state, society, and science in the two political contexts under investigation. By engaging with both the forms of knowledge that are produced in registries and posing questions that are currently not asked in data collection practices, the project actively engages with national immunization programs. The study is thus not only an innovative social-scientific endeavor, but also of potential benefit to public health.

Data is crucial in designing and implementing public health policies - and plays a particular role in governing vaccination, as the ongoing COVID19 pandemic has clearly shown. But what makes data 'good enough'? Whose data counts, and what types of data are valuable in contemporary health governance? How can data be turned into knowledge and whose interests does this knowledge serve? This project addressed these questions by studying the historical development of particular data infrastructures - so-called vaccine registries - in Austria, the Netherlands, and Norway. These databases contain important data on vaccination coverage, which in turn can help inform evidence-based policy towards effective vaccination governance. But data collection is not merely a technical exercise: politics informs decisions as to what data should be collected and to what end - such as evaluations of policy programs. Drawing on concepts and methods from political science and science and technology studies (STS), the project employed desk research, literature review, and expert interviews (n=40+) to investigate the design, use, and use of vaccination registries. We find that the very design of these registries has become subject to intense political debates across countries during the ongoing COVID19 pandemic. Across countries, the pandemic raised new questions as to what knowledge is considered valuable in contemporary governance. By the same token, we find that institutionalized ignorance continues to shape governance and regulation in and beyond the public health domain.