What Barriers Exist in the Minds of Vaccine-Hesitant Parents, and How Can We Address Them?

Abstract

Background and Objectives: Despite substantial health benefits and prolific research efforts to demonstrate safety and increase uptake, vaccine hesitancy has increased dramatically. This study aimed to systematically analyze available literature on vaccine hesitancy in the United States and determine the rationale behind vaccine-hesitant parents and potential interventions. Methods: We conducted a literature search and identified 232 articles; we included 90 after screening. We pulled information from each article using standardized questions for “type of study,” “population,” “specific vaccine,” “reasons for hesitancy,” “hesitancy prevalence,” “attempt at change,” “results of intervention,” and “future interventions.” We created recurrent themes from the data and analyzed these themes via descriptive statistics. Results: Vaccine safety was the most commonly identified reason for vaccine hesitancy amongst studies (50%), followed by not enough information (30%), side effects (26%), low risk of disease (26%), social norms (22%), vaccine schedule (21%), not recommended by doctor (21%), efficacy (18%), cost/access (13%), sexual concerns (12%) and distrust of establishment (7%). Only 20% of papers documented an intervention, and <50% of these reported increased vaccination rates or intent. More research was the most commonly identified next step (49%). Conclusions: Despite large amounts of research on vaccination rates, patients are still reporting not enough information and safety as the most common reasons for vaccine hesitancy. Interventions were few and without promising results. More research was the most suggested intervention. Such research must address concerns of the vaccine-hesitant community, comparing risks and benefits of each vaccination in a longitudinal, coherent, and transparently unbiased fashion.

Understanding COVID-19 vaccine hesitancy in Pakistan: The paradigm of Confidence, Convenience, and Complacency; A Cross-sectional study

“…Similarly, the finding that 43% agreed with administering the vaccine to children reflects a knowledge gap too, as CDC strictly prohibits the administration of the vaccine to individuals under the age of 16 years in the case of Pfizer and, 18 years in the case of the Moderna vaccine(32). Our research found that 61.7% of respondents agreed that they would vaccinate on the recommendation of a healthcare worker so having better physician recommendations is a good intervention to accentuate the success of an immunization program as also cited in previous literature(33).…”

“…In light of the scale and scope of this major issue, all government and non-governmental health care departments must work together to restore trust in vaccines. The risk of vaccine-preventable disease(VPD), benefits of a vaccine for that VPD, and the risk-benefit ratio of the vaccine need to be discussed, supported by evidence-based medicine, with the hesitant people in a longitudinal, comprehensive, coherent, and in an unbiased transparent fashion to increase vaccination uptake(33). It is important to educate the public through mass outreach initiatives, awareness campaigns, and conferences to alleviate fear and uncertainty about the safety and efficacy of all vaccines and bridge the knowledge gap(39).…”

Intention to receive a COVID-19 vaccine: results from a population-based survey in Canada

“…Ultimately, the success of any COVID-19 vaccine program depends upon vaccine uptake in the population. Over the past decade there has been a significant rise in “vaccine hesitancy”, a complex concept defined as the refusal, reluctance, or delay in acceptance to vaccinate despite vaccine availability [ 2 , 8 , 9 ], which has led to decreases in vaccine uptake [ 10 – 13 ]. Understanding the predictors and determinants influencing intentions to receive a COVID-19 vaccine in Canada are key to designing public health programming to optimize vaccination rates, including among priority populations, when vaccine is available broadly [ 6 , 7 ].…”

Intention to receive a COVID-19 vaccine: Results from a population-based survey in Canada

“…Over the past decade there has been a significant rise in "vaccine hesitancy", a complex concept defined as the refusal, reluctance, or delay in acceptance to vaccinate despite vaccine availability 2,8,9 , which has led to decreases in vaccine uptake. 10,11,12,13 Understanding the predictors and determinants influencing intentions to receive a COVID-19 vaccine in Canada are key to designing public health programming to optimize vaccination rates, including among priority populations, when vaccine is available broadly. 6,7 When evaluating vaccine intention, assessments should be based on validated theoretical frameworks in order to provide robust information for program planning.…”