Differences in viewpoints between science and society, like in for example the HPV-vaccination debate, should be considered from a socio-technical system perspective, and not solely from a boundary perspective between the lay public, medical doctors and scientists. Recent developments in the HPV-vaccination case show how the debate concerning uncertainty amongst scientists and the lay audience is mostly focussed on the improvement of understanding of lay people about why vaccination is important. This boundary thinking leads to the idea that once the boundary is crossed, the problem is solved. However, such ‘bug-fixing’ and technocentric boundary thinking is not leading to sustainable resolutions. We view science communication as a key aspect of the socio-technical system of scientific, technological and innovation development, in which the vaccine and its corresponding immunisation program are socially constructed. A process of construction that takes place all the way from the fuzzy front-end of their scientific conception until the marketing back-end. The authority, legitimacy and therefore the license to operate of scientists, engineers and policy makers are discussed, primarily at this boundary, but develops during the whole process of innovation. During upstream processes, professional roles and according behaviour are also defined.
In this commentary we state that the development of science communication strategies should also start upstream, and that the ‘bug-fixes’ of improved listening to (and not by) the lay audience, could be become a more sustainable solution to the HPV-debate if this process of listening by experts considers the socio-technical system of vaccination as a whole. One of the outcomes might be that the dialogue between scientists, policy makers and the lay audience is about the various possible scenarios that deal with inherent scientific and societal uncertainty in which the inevitable uncertainty of science becomes more explicit. It is not known according whether this will lead to more profound interactions, however we would like to explore this possibility a bit more from an uncertain innovation process point of view. This could clear the way for a process of co-inquiry into ideas concerning shared responsibility and accountability. The latter means that the focus in the debate is more balanced and concerns the social network, and is not purely focussed on the betterment ofunderstanding by the lay audience. Moreover, in this way we consider communication and interaction between actors not as a means of crossing any boundaries (since that may be impossible), but as a means to perturb a status quo or equilibrium within a network of actors. This makes apparent boundaries more explicit and discussable. Methods of interaction, e.g. based on concepts like midstream modulation, may lead to another discourse and give way to new dynamics in this social system.
