Attitudes to vaccination: A critical review

Abstract

This paper provides a consolidated overview of public and healthcare professionals' attitudes towards vaccination in Europe by bringing together for the first time evidence across various vaccines, countries and populations. The paper relies on an extensive review of empirical literature published in English after 2009, as well as an analysis of unpublished market research data from member companies of Vaccines Europe. Our synthesis suggests that hesitant attitudes to vaccination are prevalent and may be increasing since the influenza pandemic of 2009. We define hesitancy as an expression of concern or doubt about the value or safety of vaccination. This means that hesitant attitudes are not confined only to those who refuse vaccination or those who encourage others to refuse vaccination. For many people, vaccination attitudes are shaped not just by healthcare professionals but also by an array of other information sources, including online and social media sources. We find that healthcare professionals report increasing challenges to building a trustful relationship with patients, through which they might otherwise allay concerns and reassure hesitant patients. We also find a range of reasons for vaccination attitudes, only some of which can be characterised as being related to lack of awareness or misinformation. Reasons that relate to issues of mistrust are cited more commonly in the literature than reasons that relate to information deficit. The importance of trust in the institutions involved with vaccination is discussed in terms of implications for researchers and policy-makers; we suggest that rebuilding this trust is a multi-stakeholder problem requiring a co-ordinated strategy.

UNderstanding uptake of Immunisations in TravellIng aNd Gypsy communities (UNITING): a qualitative interview study

“…A large body of literature [56][57][58][59][60][61][62][63] identifies two broad categories of parental factors influencing uptake of childhood immunisation in the general population and high-risk groups. The first relates to socioeconomic disadvantage for which, despite not objecting to vaccines, parents lack access to resources and support to overcome logistical barriers such as having no private transport.…”

“…The barriers and facilitators that emerged from the interviews with Travellers and service providers are discussed in terms of the two broad categories of factors that are considered to influence the uptake of childhood and adult immunisation in the general population and high-risk groups: [56][57][58][59][60]62 acceptance of vaccines and access to health services. Together, these two categories capture the five levels of the SEM, 89 the theoretical framework underpinning this study.…”

PRECEDE- PROCEED Model on Determinants of Completeness Immunization Status among Infants in Bangkalan District, Madura

“…According to Yaqub et al(2014) doubtful attitude toward the benefits and accomplishment of immunization can be the result of health workers' attitude who is less informative about the importance of immunization.…”

Vaccine Rejecting Parents’ Engagement With Expert Systems That Inform Vaccination Programs

“…Trust arises as an issue in numerous studies of why people do and do not vaccinate their children (Mills et al 2005;Dube, Vivion, and MacDonald 2015;Yaqub et al 2014), but the extent to which trust and distrust-as distinct concepts-shape vaccination decisions remains underexplored. In this study, we theoretically analyse trust and distrust to investigate parents' perceptions of the expert systems central to vaccination policy and practice in Australia, where approximately 3.3 per cent of children are not up to date with their vaccinations due to their parent or caregiver's active rejection of some or all vaccines (Beard et al 2016).…”

“…Parents pursue health information through unfiltered channels such as the Internet (Yaqub et al 2014), which offers quick access and the advantages of interactivity, information tailoring and anonymity (Cline and Haynes 2001). Health information is one of the most frequently sought topics online (MuMullan 2006), with access growing rapidly through globalization, the diffusion of the news media, and social networking.…”