Elsevier

Vaccine

Volume 32, Issue 49, 20 November 2014, Pages 6649-6654
Vaccine

Mapping vaccine hesitancy—Country-specific characteristics of a global phenomenon

https://doi.org/10.1016/j.vaccine.2014.09.039Get rights and content
Under a Creative Commons license
open access

Highlights

  • Vaccine hesitancy is a global problem that is complex and multilayered. Vaccine hesitancy is context, time, place and vaccine specific.

  • Interviews with immunization managers were conducted to determine the breadth and perceived drivers of vaccine hesitancy at the countries’ level.

  • Our study results, not unexpectedly, revealed a wide variation in the reported basis for vaccine hesitancy across countries.

Abstract

The term vaccine hesitancy refers to delay in acceptance or refusal of vaccines despite the availability of vaccination services. Different factors influence vaccine hesitancy and these are context-specific, varying across time and place and with different vaccines. Factors such as complacency, convenience and confidence are involved. Acceptance of vaccines may be decreasing and several explanations for this trend have been proposed. The WHO Strategic Advisory Group of Experts (SAGE) on Immunization has recognized the global importance of vaccine hesitancy and recommended an interview study with immunization managers (IMs) to better understand the range of vaccine hesitancy determinants that are encountered in different settings. Interviews with IMs in 13 selected countries were conducted between September and December 2013 and various factors that discourage vaccine acceptance were identified. Vaccine hesitancy was not defined consistently by the IMs and most interpreted the term as meaning vaccine refusal. Although vaccine hesitancy existed in all 13 countries, some IMs considered its impact on immunization programmes to be a minor problem. The causes of vaccine hesitancy varied in the different countries and were context-specific, indicating a need to strengthen the capacity of national programmes to identify the locally relevant causal factors and to develop adapted strategies to address them.

Keywords

Vaccine hesitancy
Immunization
Determinants
Vaccination
Interviews
Immunization managers

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