Measuring vaccine hesitancy: The development of a survey tool.

In March 2012, the SAGE Working Group on Vaccine Hesitancy was convened to define the term "vaccine hesitancy", as well as to map the determinants of vaccine hesitancy and develop tools to measure and address the nature and scale of hesitancy in settings where it is becoming more evident. The definition of vaccine hesitancy and a matrix of determinants guided the development of a survey tool to assess the nature and scale of hesitancy issues. Additionally, vaccine hesitancy questions were piloted in the annual WHO-UNICEF joint reporting form, completed by National Immunization Managers globally. The objective of characterizing the nature and scale of vaccine hesitancy issues is to better inform the development of appropriate strategies and policies to address the concerns expressed, and to sustain confidence in vaccination. The Working Group developed a matrix of the determinants of vaccine hesitancy informed by a systematic review of peer reviewed and grey literature, and by the expertise of the working group. The matrix mapped the key factors influencing the decision to accept, delay or reject some or all vaccines under three categories: contextual, individual and group, and vaccine-specific. These categories framed the menu of survey questions presented in this paper to help diagnose and address vaccine hesitancy

Communication Strategies to Address Vaccine Hesitancy in Healthcare Settings and on Social Media

Abstract Vaccine hesitancy is now recognized as a threat to global health. Its causes are complex, and it is defined by a resistance to or questioning of immunization. It is important to address vaccine hesitancy directly before people who are hesitant become vaccine refusers or anti-vaccine. Fortunately, with evidence-based information delivered with a compassionate communication style many of those who are hesitant to vaccinate can be persuaded to ultimately vaccinate. This paper aims to explain successful communication strategies used to address vaccine hesitancy in healthcare settings and on social media. Vaccine hesitant parents frequently list their child’s healthcare provider as a trusted source of information on vaccine issues. Research has shown that using presumptive language for vaccine introduction, followed by a compassionate and direct response to any concerns is an effective form of communication with vaccine hesitant parents. This paper teaches the C.A.S.E. Model as a way to formulate that communication. Although many people trust their providers, we cannot ignore the influence of the Internet, specifically social media, as a source of vaccine information for patients and parents. Although there is much pro-vaccine messaging on the Internet, the anti-vaccine messaging is frequently simpler, more emotionally appealing, and easily sharable. Since vaccine hesitant people tend to be silent observers of the vaccine debate online, it is important for pro-vaccine sources to communicate effectively in this arena. We describe our experience and lessons learned with this form of communication through the pro-immunization parent advocacy group, Immunize Texas

The Correlation Between Vaccine Hesitancy and Privilege: Exploring the degree to which education and income foster resistance to vaccination efforts

Vaccine hesitancy is a public health issue of growing concern. Extensive pre-existing literature offers several explanations and conflicting viewpoints regarding reluctance toward vaccinations. However, minimal research has been done exploring the upstream social determinants driving vaccine hesitancy. Utilizing academic and gray literature and interviews with experts in the field, this study addresses this gap in knowledge with the research question: To what extent does privilege impact vaccine hesitancy and resistance? Vaccine hesitancy appears globally and is particularly concerning given the re-emergence of vaccine-preventable diseases (VPDs). Additionally, due to inconsistent causes, vaccine hesitancy is difficult to combat. In referencing the history of the anti-vaccination movement and clearly defining social determinants of health (SDH), this study provides clear evidence that suggests a relationship between vaccine hesitancy and privilege, defined as educational achievement and socio-economic status (SES). Nevertheless, the association between the two is difficult to define given the dichotomous presentation of both low and high privilege with increased vaccine hesitancy. Perhaps knowledge of the relationship of vaccine reluctance with the two extremes of privilege can pave the way for future research into the understanding of this phenomenon

Addressing Vaccine Hesitancy with Motivational Interviewing: A Pilot Study

Statement of the problem: The unprecedented 2019 Measles outbreaks in the US and the current COVID 19 global pandemic highlight the necessity of addressing vaccine hesitancy. Improving vaccine confidence requires strategic communication approaches that focus on addressing the complex reasons for vaccine hesitancy. Purpose: The purpose of this project was to improve both provider’s understanding of the complex factors involved in vaccine hesitancy and confidence in using motivational interviewing to address vaccine hesitancy. Intervention: An educational presentation for advanced practice nurses was conducted with the purpose of highlighting the benefits of using motivational interviewing in vaccine hesitant patients. Results: The presentation to nurse practitioners in San Diego led to improvement in ability to assess for vaccine hesitancy and improvement in knowledge of motivational interviewing. Conclusions: This project shows that continued research into effective interventions is a necessary approach in confronting the complex challenges of vaccine hesitancy

A Systematic Review on Sociodemographic, Financial and Psychological Factors Associated with COVID-19 Vaccine Booster Hesitancy among Adult Population

Background: While considerable evidence supports the safety and efficacy of COVID-19 vaccines, a sizable population expresses vaccine hesitancy. As per the World Health Organization, vaccine hesitancy is one of the top 10 hazards to global health. Vaccine hesitancy varies across countries, with India reporting the least vaccine hesitancy. Vaccine hesitancy was higher toward COVID-19 booster doses than previous shots. Therefore, identifying factors determining COVID-19 vaccine booster hesitance (VBH) is the sine qua non of a successful vaccination campaign. Methodology: This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) 2020 standards. A total of 982 articles were pooled from Scopus, PubMed and Embase, while 42 articles that addressed the factors of COVID-19 VBH were finally included for further analysis. Result: We identified factors responsible for VBH and divided them into three major groups: sociodemographic, financial, and psychological. Hence, 17 articles stated age to be a major factor for vaccine hesitancy, with most reports suggesting a negative correlation between age and fear of poor vaccination outcomes. Nine studies found females expressing greater vaccine hesitancy than males. Trust deficit in science (n = 14), concerns about safety and efficacy (n = 12), lower levels of fear regarding infection (n = 11), and worry about side effects (n = 8) were also reasons for vaccine hesitancy. Blacks, Democrats, and pregnant women showed high vaccine hesitancy. Few studies have stated income, obesity, social media, and the population living with vulnerable members as factors influencing vaccine hesitancy. A study in India showed that 44.1% of vaccine hesitancy towards booster doses could be attributed dominantly to low income, rural origin, previously unvaccinated status, or living with vulnerable individuals. However, two other Indian studies reported a lack of availability of vaccination slots, a lack of trust in the government, and concerns regarding safety as factors for vaccine hesitancy toward booster doses. Conclusion: Many studies have confirmed the multifactorial nature of VBH, which necessitates multifaceted, individually tailored interventions that address all potentially modifiable factors. This systematic review chiefly recommends strategizing the campaign for booster doses by identifying and evaluating the reasons for vaccine hesitancy, followed by appropriate communication (at both individual and community levels) about the benefits of booster doses and the risk of losing immunity without them

Factors affecting vaccine hesitancy among families with children 2 years old and younger in two urban communities in Manila, Philippines

Objective: The study aimed to determine the factors that influence vaccine hesitancy among parents and caregivers ofchildren 2 years old and younger in selected urban communities in Manila, Philippines. Methodology: The study used a cross-sectional study design with a modified questionnaire adapted from the SAGEWorking Group on Vaccine Hesitancy. Self-administered surveys were conducted in two highly urbanized barangays(smallest administrative divisions) in Manila, Philippines. Results: The survey was completed by 110 respondents, comprised mostly of 20–39-year-old mothers. Most respondents(95.5%) believed that vaccines are protective however vaccine hesitancy rates among the respondents reached 36.4%.Respondents who believed in the protective nature of vaccines were less likely to report vaccine hesitancy and were ninetimes less likely to refuse vaccination for their children because of negative media exposure. The main reasons identifiedfor vaccine hesitancy were exposure to negative media information and concerns about vaccine safety. The main negativemedia information identified by the respondents was related to the dengue vaccine, Dengvaxia®. Health-care workers andpolitical leaders were the main supporters of vaccination in the community. Discussion: The recent events surrounding the Dengvaxia® controversy contributed to a decrease in vaccine confidence.The role of mass media in vaccine hesitancy was highlighted in this study, supporting previous evidence that vaccinehesitantparents tend to be more susceptible to media reports. The lack of association between sociodemographic factorsand vaccine hesitancy implies that the determinants of vaccine hesitancy can be highly varied depending on context andsetting

Antecedents of Vaccine Hesitancy in WEIRD and East Asian Contexts

Following decreasing vaccination rates over the last two decades, understanding the roots of vaccine hesitancy has become a public health priority. Vaccine hesitancy is linked to scientifically unfounded fears around the MMR vaccine and autism which are often fuelled by misinformation spread on social media. To counteract the effects of misinformation about vaccines and in particular the falling vaccination rates, much research has focused on identifying the antecedents of vaccine hesitancy. As antecedents of vaccine hesitancy are contextually dependent, a one-size-fits-all approach is unlikely to be successful in non-WEIRD (Western, Educated, Industrialised, Rich, and Democratic) populations, and even in certain (non-typical) WEIRD sub-populations. Successful interventions to reduce vaccine hesitancy must be based on understanding of the specific context. To identify potential contextual differences in the antecedents of vaccine hesitancy, we review research from three non-WEIRD populations in East Asia, and three WEIRD sub-populations. We find that regardless of the context, mistrust seems to be the key factor leading to vaccine hesitancy. However, the object of mistrust varies across WEIRD and non-WEIRD populations, and across WEIRD subgroups suggesting that effective science communication must be mindful of these differences

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

AbstractThe 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

Report 43: Quantifying the impact of vaccine hesitancy in prolonging the need for Non-Pharmaceutical Interventions to control the COVID-19 pandemic

Vaccine hesitancy – a delay in acceptance or refusal of vaccines despite availability 1 – has the potential to threaten the successful roll-out of SARS-CoV-2 vaccines globally 2 . Here, we evaluate the potential impact of vaccine hesitancy on the control of the pandemic and the relaxation of non-pharmaceutical interventions (NPIs) by combining an epidemiological model of SARS-CoV-2 transmission 3 with data on vaccine hesitancy from population surveys. Our findings suggest that the mortality over a 2-year period could be up to 8 times higher in countries with high vaccine hesitancy compared to an ideal vaccination uptake if NPIs are relaxed. Alternatively, high vaccine hesitancy could prolong the need for NPIs to remain in place. Addressing vaccine hesitancy with behavioural interventions is therefore an important priority in the control of the COVID-19 pandemic