Managing Dissonance and Dissent: Bureaucratic Professionalism and Political Risk in Policy Implementation

This article examines the implementation of a Michigan rule requiring vaccine-critical parents to attend an education session at a local health department prior to receiving an immunization waiver. During interviews (N = 35), public health professionals recognized that providing waivers deviated from their professional mission. Yet, they chose to prioritize client service in their interactions, thereby managing and absorbing conflict at the parent level. Politically, vaccine critics have succeeded in proposing bills to undo this rule. This suggests that conflict management and absorption is a vital policy function because conflict can turn into political action, endangering the future of a promising rule.