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Service Personalization as a Response to Noncompliance with Routine Childhood Vaccination

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Abstract

Governmental reaction to citizens’ noncompliance with policy is often portrayed as a retrospective enforcement effort, in which incentives and information serve as the main mechanisms to change citizens’ noncompliant behavior. This study suggests that government may adapt existing policy arrangements to encourage compliance rather than enforce implementation. Such responses recognize that noncompliance is an ongoing decision-making process rather than a single event, with scope for government intervention at different points. Drawing on toddlers’ nonvaccination in Israel as a test case, findings indicate that to minimize noncompliance and its public health implications, officials have responded by personalizing the standardized service. Personalization is a pragmatic response that recognizes that hesitant parents may be amenable to modified interventions as an alternative to complete exit. Nevertheless, personalization challenges the very notion of a public health intervention based on a standard protocol and raises new dilemmas around where private responsibilities end and public ones begin.

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