Addressing barriers to vaccine acceptance: an overview

Abstract

Addressing the drivers of vaccine hesitancy and the barriers to vaccine acceptance is a complex but important task. While the percentage of hesitant does vary from country to country and in time few, if any, countries are ever free from this problem. Overcoming hesitancy requires detection, diagnosis and tailored intervention as there is no simple strategy that can address all of the barriers to vaccine acceptance. Immunization program managers and health care workers need to become adept at recognizing and tackling hesitancy in all of its incarnations if high levels of vaccine acceptance are to be achieved but must also actively support immunization acceptors in order to build and support vaccine acceptance resiliency. This paper presents evidence-informed strategies to achieve these goals.

Vaccination Coverage Among Children Aged 19–35 Months — United States, 2017

“…Unvaccinated children in the 2017 NIS-Child were disproportionately uninsured: 17.2% of unvaccinated children were uninsured, compared with 2.8% of all children. Evidence-informed strategies addressing parents’ decisions about vaccinating their children could focus on both programs and individual patients, such as vaccine delivery through school programs, strong recommendations by providers to parents to vaccinate their children, and reinforcement of the importance of community protection through vaccination ( 7 ). …”

Factors influencing vaccine acceptance and hesitancy in three informal settlements in Lusaka, Zambia

“…To maximize uptake, educational and vaccination campaigns should align with communities’ preferences for delivery on weekend, door-to-door and by volunteers from the same communities. Educational and engagement efforts should target key influencers such as elders and religious leaders and also be embedded in services for key groups such as pregnant women [32] , [33] . Based on our research, education should provide information on vaccines’ aim and possible adverse effects, to limit the spread of rumours and distrust.…”

“…Based on our research, education should provide information on vaccines’ aim and possible adverse effects, to limit the spread of rumours and distrust. Furthermore, to address misconceptions about vaccine effectiveness and prevent future frustration leading to vaccine hesitancy, vaccine-related education should be pre-emptive, differentiate between vaccines and other medical products using clear language, and be clear with regards to the effectiveness of different vaccines [33] . Increased transparency and information to communities through trained community advisory boards selected from the same community also seems a promising approach to improve understanding [34] .…”

Maternal vaccine knowledge in low- and middle-income countries—and why it matters

“…Many healthcare professionals still maintain skepticism about maternal vaccinations, which can be easily transferred to the patients. 31 A consistent message across an entire healthcare workforce will fill in maternal knowledge gaps which will in turn reduce vaccine hesitancy. Secondly, SAGE, which already notes knowledge, attitudes, and beliefs as drivers of vaccine hesitancy, should prioritize acceptability in their review for a new vaccine introduction for maternal vaccines, as research outlined above has indicated its importance in maternal decision-making and ultimate vaccine uptake.…”

“…27 A strong communication strategy should also include culturally and contextually appropriate messaging that addresses the values, beliefs and norms of the groups and subgroups of populations, to address the attitudes and beliefs that could influence a mother's intention to vaccinate. 31 Maternal vaccines contain great potential to reduce the global burden of infant morbidity and mortality, with their unique position to access the infant's immune system through maternal antibodies before a child vaccine could be effective. However, vaccine hesitancy, driven largely by maternal knowledge of vaccines, threatens to curtail the potential successes of such vaccines, thereby hindering public health goals to reduce the global burden of neonatal infectious disease and mortality.…”