title: Negotiating vaccine acceptance in an era of reluctance.
abstract: Studies to better understand the determinants of vaccine acceptance have expanded to include more investigation into dynamics of individual decision-making as well as the influences of peers and social networks. Vaccine acceptance is determined by a range of factors, from structural issues of supply, costs and access to services, as well as the more demand-side determinants. The term vaccine hesitancy is increasingly used in the investigation of demand-side determinants, moving away from the more polarized framing of pro- and anti-vaccine groups to recognizing the importance of understanding and engaging those who are delaying vaccination, accepting only some vaccines, or who are yet undecided, but reluctant. As hesitancy is a state of indecision, it is difficult to measure, but the stage of indecision is a critical time to engage and support the decision-making process. This article suggests modes of investigating the determinants of vaccine confidence and levers of vaccine acceptance toward better engagement and dialogue early in the process of decision-making. Pressure to vaccinate can be counter-productive. Listening and dialog can support individual decision-making and more effectively inform the public health community of the issues and concerns influencing vaccine hesitancy.
authors.affiliation: Department of Infectious Disease Epidemiology; London School of Hygiene & Tropical Medicine; London, UK.
authors.forename: Heidi J
authors.initials: HJ
authors.lastname: Larson
mesh_terms: D006266:Health Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011369:Professional-Patient Relations; D014611:Vaccination / Q000523:psychology / Q000706:statistics & numerical data*; D014612:Vaccines / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D014612:Vaccines
keywords: confidence; hesitancy; immunisation; immunization; trust; vaccine acceptance
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