Vaccine hesitancy: understanding better to address better

Abstract

Vaccine hesitancy is an emerging term in the socio-medical literature which describes an approach to vaccine decision making. It recognizes that there is a continuum between full acceptance and outright refusal of some or all vaccines and challenges the previous understanding of individuals or groups, as being either anti-vaccine or pro-vaccine. The behaviours responsible for vaccine hesitancy can be related to confidence, convenience and complacency. The causes of vaccine hesitancy can be described by the epidemiological triad i.e. the complex interaction of environmental- (i.e. external), agent- (i.e. vaccine) and host (or parent)- specific factors. Vaccine hesitancy is a complex and dynamic issue; future vaccination programs need to reflect and address these context-specific factors in both their design and evaluation. Many experts are of the view that it is best to counter vaccine hesitancy at the population level. They believe that it can be done by introducing more transparency into policy decision-making before immunization programs, providing up-to-date information to the public and health providers about the rigorous procedures undertaken before introduction of new vaccines, and through diversified post-marketing surveillance of vaccine-related events.

Chronic Living in a Communicable World

“…But, concurrently, acute infections have been assumed largely resolved, predominantly because of the effectiveness of early public health interventionsimprovements in water and sanitation to address water-borne, food-borne, and waterwash infections, and vaccinations against specific viruses (polio, measles, diphtheria, etc. ), even while distrust in the efficacy, safety, and delivery of vaccinations have led to growing vaccine hesitance (Dube et al 2015;Kumar et al 2016;Larson et al 2014;Smith 2017). Concurrent with vaccination refusal, there has been considerable recalcitrance to health messages to reduce the use of antibiotics to head off antimicrobial resistance ).…”

A descriptive qualitative study of perceptions of parents on their child's vaccination

“…Parents regarded bringing their child to vaccination as a social responsibility (Tickner, Leman, & Woodcock, ) or as a common sense notion of “just something you do” (Austvoll‐Dahlgren & Helseth, ). However, even in communities with high vaccination rates, having low confidence in vaccination decisions was commonly reported by parents (Austvoll‐Dahlgren & Helseth, ; Kumar, Chandra, Mathur, Samdariya, & Kapoor, ). They had multiple concerns, such as adverse effects (Delkhosh, Negarandeh, Ghasemi, & Rostami, ; Stefanoff et al., ), vaccination safety (Gust, Brown, et al., ; Gust et al., ; Stefanoff et al., ) and vaccination‐related pain (Delkhosh et al., ; Gust, Brown, et al., ; Gust, Kennedy, et al., ; Kennedy, Basket, & Sheedy, ) or persisting misperceptions regarding vaccination, despite parents adhering to recommended immunisation schedules (Kennedy, LaVail, Nowak, Basket, & Landry, ).…”

Parental regret regarding children’s vaccines—The correlation between anticipated regret, altruism, coping strategies and attitudes toward vaccines

“…However, ensuring widespread vaccination coverage is complicated by a wide range of factors, including vaccine hesitancy, which leads to uncertainty in segments of the public about the safety and efficacy of vaccinations. Actually, decision-making regarding vaccination is a complex process which is dependent on emotional, cultural, social, spiritual and political factors as well as on cognitive factors [2]. According to the World Health organization (WHO), vaccine hesitancy refers to a delay in acceptance or refusal of vaccines despite availability of vaccination services [3].…”

“…Action or inaction toward vaccination might result in feelings of regret, which is the aversive interplay of feelings resulting from the comparison of a selected choice and a non-selected alternative [5]. In light of this, Kumar et al [2] claimed that the causes of vaccine hesitancy can be described as a complex interaction of external, agent-specific and host-specific factors such as immunization requirements, policies, media, norms, vaccine-efficacy, vaccine safety, race, education, income and knowledge about vaccines. However, despite their valuable contribution to the understanding of vaccine hesitancy, psychological factors have not received much attention in their review.…”