Vaccine Hesitancy: Drivers and How the Allergy Community Can Help

Abstract

Vaccine hesitancy—defined by the World Health Organization (WHO) as a “delay in acceptance or refusal of vaccines despite availability of vaccination services”—is not a recent phenomenon. Historical records indicate that vaccine hesitancy existed by the 18th century in Europe and even resulted in violent riots. The drivers of vaccine hesitancy have evolved over the last 200 years but not, perhaps, as much as one might expect. More problematic are the means by which concerns over vaccine hesitancy are communicated by a new landscape of digital communication, generating what has been described as an “infodemic” in which an overabundance of information—both factual and misinformation—contributes to hesitancy. In this review, we discuss the background and current drivers of vaccine hesitancy and the evidence base for strategies to combat this. We highlight the important role the allergy/immunology community could have in working to mitigate vaccine hesitancy, particularly with respect to the current coronavirus disease 2019 (COVID-19) pandemic.

Targeting COVID Vaccine Hesitancy in Rural Communities in Tennessee: Implications for Extending the COVID-19 Pandemic in the South

“…COVID-19 vaccine hesitancy may be defined as a reluctance or unwillingness to be vaccinated or have one's children vaccinated against the disease, even if proven safe and effective [16][17][18]. Vaccine hesitancy is among the top 10 global health threats identified by the World Health Organization in 2019 [19].…”

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“…In particular, these factors included low educational level, younger age, low level of epistemic trust, avoidance of uncertainty, extraversion, collective narcissism, a conspiracy-prone mindset, high level of self-perceived risk, and anxiety [23]. Possible reasons for susceptibility for vaccine hesitancy are mistrust of doctors, health services, the government, the pharmaceutical industry, safety concerns, complacency over low perceived personal risks, misinformation, religious beliefs, dietary restrictions, historical concerns, a particular lifestyle ("natural medicine"), or COVID-19 denial [34].…”

“…The infodemic can lead to deception resulting in poor and erroneous decision making. The overabundance of factual and misinformation contributed to vaccine hesitancy [34]. Rapidly disseminated, low-quality scientific output such as systematic reviews not properly conducted, but labeled as such, which may not immediately be visible to the reader, can lead to inaccurate representation of scientific evidence, inaccurate estimates of the treatment effectiveness, misleading conclusions, and reduced applicability [16].…”

“…Likewise, unscientific and unproven cures were harmful [21]. An important example was vaccine hesitancy which left non-vaccinated individuals unprotected and was fueled though uncertainty due to the infodemic and misinformation [34]. Misinformation could induce hazardous behavior; the distrust in scientific and public institutions as well as the confidence crisis triggered by the infodemic resulted in harmful health behavior and also had an impact on mental health.…”

“…In addition, evidence synthesis and knowledge translation can be useful tools to communicate accurate scientific information to decision-makers [14,38]. Implementing community centered measures driven by stakeholders and role models can help producing orientation, reducing uncertainties, and building as well as maintaining trust [18,22,34].…”