Vaccine hesitancy, refusal and access barriers: The need for clarity in terminology

Bedford, Helen; Attwell, Katie; Danchin, Margie; Marshall, Helen; Corben, Paul; Leask, Julie

doi:10.1016/j.vaccine.2017.08.004

Cited by 245 publications

(203 citation statements)

References 18 publications

Supporting

Mentioning

200

Contrasting

Unclassified

Order By: Relevance

“…Cost, accessibility and social norms also can play major roles. We therefore advocate that the term 'vaccine hesitancy' be applied only to individuals who are undecided and not to logistical or opportunity-related factors [60]. Although vaccine hesitancy has existed since the advent of vaccines, it is now supported and amplified by information easily available on the internet.…”

Section: Vaccine Hesitancy and Refusalmentioning

confidence: 99%

“…Although widespread vaccine hesitancy is an important hurdle to attaining optimal vaccination coverage, it is far from being the only obstacle: other factors such as accessibility and public health support may be as important or more important [60]. Nonetheless, in terms of changing perception and support for vaccination it cannot be ignored.…”

Section: Addressing Vaccine Uptake By Understanding and Including Pubmentioning

confidence: 99%

See 1 more Smart Citation

Life-course immunization as a gateway to health

Philip

Attwell

Breuer

et al. 2018

Expert Review of Vaccines

Self Cite

View full text Add to dashboard Cite

Introduction: Extending the benefits of vaccination against infectious diseases from childhood throughout the entire lifespan is becoming an increasingly urgent priority in view of the world's aging population, emergence and reemergence of infectious diseases, and the necessity to invest more on prevention versus cure in global healthcare. Areas covered: This perspective discusses how life-course immunization could benefit human health at all stages of life. To achieve this, the current vaccination paradigm should be changed and all stakeholders have a role to play. Expert commentary: To enhance immunization confidence in the population, it is essential that stakeholders eliminate complacency toward infectious diseases, improve vaccination convenience, remove barriers among different healthcare specialties, and address prevention as a single entity. They must also consider societal and cultural mindsets by understanding and including public viewpoints. A new "4Cs' model encompassing convenience, confidence, complacency, and cultural acceptance is proposed to convert 'vaccine availability' to 'vaccination acceptance' throughout life. Life-course vaccination should become the new social norm of a healthy lifestyle , along with a healthy diet, adequate physical exercise, and not smoking. We are 'all in' to make life-course immunization a gateway for all people to lead longer, healthier lives.

show abstract

Section: Vaccine Hesitancy and Refusalmentioning

confidence: 99%

Section: Addressing Vaccine Uptake By Understanding and Including Pubmentioning

confidence: 99%

Life-course immunization as a gateway to health

Philip

Attwell

Breuer

et al. 2018

Expert Review of Vaccines

Self Cite

View full text Add to dashboard Cite

show abstract

“…These are scope (which vaccines are mandated), sanctions and their severity (what happens when you don't vaccinate), and selectivity (the management of enforcement and exemptions). As we explore each of these policy components, we engage with the important question of whether and how so‐called mandatory vaccination systems target the vaccination status of the cohorts that can be undervaccinated in a population: those who are undervaccinated due to access reasons (poor system reach) and those who have ready access to vaccines but may choose not to vaccinate based on the belief that not receiving the vaccine is a better option . We can further split this latter group into two subgroups—those who are considering refusing vaccines but might be swayed by mandatory policies, and committed refusers—and we consider the capacity of the policy components to work on these subgroups too.…”

mentioning

confidence: 99%

Childhood Vaccination Mandates: Scope, Sanctions, Severity, Selectivity, and Salience

Attwell

Navin

2019

Milbank Quarterly

Self Cite

View full text Add to dashboard Cite

We offer the first systematic conceptual framework for analyzing the operation of mandatory vaccination policies. Our multicomponent framework facilitates synthesis judgments on single issues of pressing concern to policymakers, in particular, how mandatory vaccination policies motivate people to vaccinate. We consider the impact of each component of our framework on persons who remain unvaccinated for different reasons, including complacency, social disadvantage, and more or less committed forms of refusal. Context In response to outbreaks of vaccine‐preventable disease and increasing rates of vaccine refusal, some political communities have recently implemented coercive childhood immunization programs, or they have made existing childhood immunization programs more coercive. Many other political communities possess coercive vaccination policies, and others are considering developing them. Scholars and policymakers generally refer to coercive immunization policies as “vaccine mandates.” However, mandatory vaccination is not a unitary concept. Rather, coercive childhood immunization policies are complex, context‐specific instruments. Their legally and morally significant features often differ, and they are imposed by political communities in varying circumstances and upon diverse populations. Methods In this paper, we introduce a taxonomy for classifying real‐world and theoretical mandatory childhood vaccination policies, according to their scope (which vaccines to require), sanctions and severity (which kind of penalty to impose on vaccine refusers, and how much of that penalty to impose), and selectivity (how to enforce or exempt people from vaccine mandates). Findings A full understanding of the operation of a vaccine mandate policy (real or potential) requires attention to the separate components of that policy. However, we can synthesize information about a policy's scope, sanctions, severity, and selectivity to identify a further attribute—salience—which identifies the magnitude of the burdens the state imposes on those who are not vaccinated. Conclusion Our taxonomy provides a framework for forensic examination of current and potential mandatory vaccination policies, by focusing attention on those features of vaccine mandates that are most relevant for comparative judgments.

show abstract

“…The sample included 10 parents who had never vaccinated their children, 5 who had ceased, 2 who were selectively vaccinating and 3 who had delayed but were now up to date. Such diversity was not explicitly sought, but expected on the basis that 'vaccine hesitancy' has been used to cover a range of beliefs and behaviours [28,29]. While all transcripts were analysed for this study, almost all the respondents cited were currently eschewing all vaccines.…”

mentioning

confidence: 99%