Vaccine Hesitancy

Nature

Complex and context-specific, varying across time, place, and vaccines

Spectrum

Ranges from refusal to delay to acceptance with concerns

Definition

Delay in acceptance, or refusal of vaccines despite availability and supporting evidence

Consequence

Disease outbreaks

Contributing Factor

Compulsory nature of vaccines

Vaccine hesitancy is a delay in acceptance, or refusal of vaccines despite availability and supporting evidence. The term covers refusals to vaccinate, delaying vaccines, accepting vaccines but remaining uncertain about their use, or using certain vaccines but not others. Although adverse effects associated with vaccines are occasionally observed, the scientific consensus that vaccines are generally safe and effective is overwhelming. Vaccine hesitancy often results in disease outbreaks and [...] Vaccine hesitancy is complex and context-specific, varying across time, place and vaccines. It can be influenced by factors such as lack of proper scientifically based knowledge and understanding about how vaccines are made or work, as well as psychological factors including fear of needles and distrust of public authorities, a person's lack of confidence (mistrust of the vaccine and/or healthcare provider), complacency (the person does not see a need for the vaccine or does not see the value [...] Several vaccination myths contribute to parental concerns and vaccine hesitancy. These include the alleged superiority of natural infection when compared to vaccination, questioning whether the diseases vaccines prevent are dangerous, whether vaccines pose moral or religious dilemmas, suggesting that vaccines are not effective, proposing unproven or ineffective approaches as alternatives to vaccines, and conspiracy theories that center on mistrust of the government and medical institutions.

The World Health Organization Strategic Advisory Group of Experts on Immunization Working Group (SAGE) defines vaccine hesitancy as refusal of vaccine or delay in its acceptance.2 Vaccine hesitancy is complex and influenced by various factors, including cultural norms, historical context, socioeconomic limitations, and personal experience. Addressing this multifaceted challenge calls for targeted interventions that acknowledge and respond to diverse concerns about efficacy and safety and [...] Vaccine hesitancy is a long-standing issue that became alarming at the height of the COVID-19 pandemic, fueled by misinformation and amplified through social media channels. Unfamiliarity with the virus led to widespread skepticism about the COVID-19 vaccine’s safety. The pandemic taught us the importance of incorporating vaccination into routine clinical practice and counseling patients about vaccines and their potential side effects. It also underscored the importance of including vulnerable [...] Safety concerns about vaccine are among the most common reasons for vaccine hesitancy. Individuals may worry about potential side effects or long-term health risks associated with vaccination, particularly for newer vaccines or those developed rapidly, such as COVID-19 vaccines.

Vaccine hesitancy reflects concerns about the decision to vaccinate oneself or one’s children. There is a broad range of factors contributing to vaccine hesitancy, including the compulsory nature of vaccines, their coincidental temporal relationships to adverse health outcomes, unfamiliarity with vaccine-preventable diseases, and lack of trust in corporations and public health agencies. Although vaccination is a norm in the U.S. and the majority of parents vaccinate their children, many do so [...] Vaccine hesitancy reflects concerns about the decision to vaccinate oneself or one’s children. Concerns that contribute to hesitancy may be based upon the perceived need for vaccination as well as the perceived risks and benefits of vaccination. A recent report from the Strategic Advisory Group of Experts (SAGE) on Immunization of the WHO defines vaccine hesitancy as “delay in acceptance or refusal of vaccines despite availability of vaccinations services. Vaccine hesitancy is complex and [...] Hesitant individuals include those who refuse some or all vaccines, delay some vaccines perhaps according to an “alternative schedule,” or accept all vaccines but remain concerned. Hesitancy is on a continuum and can be measured by assessing attitudes and beliefs toward infectious diseases and the vaccines used to prevent them. Although attitudes and beliefs that measure concerns are associated with vaccine acceptance, delay, and refusal, they do not perfectly predict vaccination decisions, as

In “The Vaccine-Hesitant Moment,” a paper by Dr. Heidi J. Larson et al. published in the New England Journal of Medicine, the authors define “vaccine hesitancy as a state of indecision and uncertainty that precedes a decision to become (or not become) vaccinated.” They note an overall lack of consensus on the definition of vaccine hesitancy: