Contesting Expertise and Constructing Parental Epistemologies: Vaccine Hesitancy and Alternative Expertise in a Free-Vax Association in Italy

This PhD thesis examines parental vaccine hesitancy as a situated and reflexive form of reasoning, challenging deficit-based interpretations that frame hesitancy primarily in terms of misinformation, irrationality, or lack of trust. Drawing on Science and Technology Studies (STS), the sociology of science, and the sociology of health, the thesis conceptualizes vaccines as socio-technical objects whose authority and meanings are co-produced through scientific practices, policy instruments, institutional communication, and everyday parental experiences. The study addresses a central mismatch between how vaccine hesitancy is governed and how parents reason through vaccination decisions. It is guided by five research questions: (1) how vaccine-hesitant parents articulate their motivations and positions; (2) how experiential, affective, and biographical factors shape vaccine decision-making; (3) how parental narratives and orientations toward vaccination evolve over time and across contexts; (4) how the COVID-19 pandemic reconfigured these processes; and (5) how parents engage with scientific authority and alternative forms of knowledge. Empirically, the thesis is based on qualitative research conducted in the Autonomous Province of Trento (Italy), focusing on parents involved in Vaccinare Informati, an association providing information, support, and advocacy around vaccination and health-related decision-making. The study draws on semi-structured interviews and participant observation and adopts a multi-strategy qualitative approach combining Qualitative Content Analysis and Thematic Analysis. The findings develop three interrelated contributions. First, the thesis examines the social consequences of vaccination mandates, showing how sanction-based governance reshapes family life, social relations, and experiences of institutional exclusion. Second, it conceptualizes vaccine decision-making as an iterative and biographically embedded form of care work. Third, it analyzes parental engagements with science and expertise, advancing a nuanced account of conditional trust, reflexive vigilance, and selective engagement with biomedical authority. Across these dimensions, the thesis introduces the concept of parental epistemologies to capture how parents actively construct, evaluate, and legitimize knowledge in morally charged contexts. Vaccine hesitancy thus emerges not as epistemic deficiency, but as a form of engaged citizenship characterized by procedural coherence, epistemic plurality, and sustained epistemic labor.