title: Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: a systematic review of published literature, 2007-2012.
abstract: Vaccine "hesitancy" is an emerging term in the literature and discourse on vaccine decision-making and determinants of vaccine acceptance. It recognizes a continuum between the domains of vaccine acceptance and vaccine refusal and de-polarizes previous characterization of individuals and groups as either anti-vaccine or pro-vaccine. The primary aims of this systematic review are to: 1) identify research on vaccine hesitancy; 2) identify determinants of vaccine hesitancy in different settings including its context-specific causes, its expression and its impact; and 3) inform the development of a model for assessing determinants of vaccine hesitancy in different settings as proposed by the Strategic Advisory Group of Experts Working Group (SAGE WG) for dealing with vaccine hesitancy. A broad search strategy, built to capture multiple dimensions of public trust, confidence and hesitancy around vaccines, was applied across multiple databases. Peer-reviewed studies were selected for inclusion if they focused on childhood vaccines [≤ 7 years of age], used multivariate analyses, and were published between January 2007 and November 2012. Our results show a variety of factors as being associated with vaccine hesitancy but they do not allow for a complete classification and confirmation of their independent and relative strength of influence. Determinants of vaccine hesitancy are complex and context-specific - varying across time, place and vaccines.
authors.affiliation: Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom. Electronic address: Heidi.larson@lshtm.ac.uk.
authors.forename: Heidi J
authors.initials: HJ
authors.lastname: Larson
authors.affiliation: Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom. Electronic address: Caitlin.jarrett@lshtm.ac.uk.
authors.forename: Caitlin
authors.initials: C
authors.lastname: Jarrett
authors.affiliation: Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom. Electronic address: Elisabeth.eckersberger@lshtm.ac.uk.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Eckersberger
authors.affiliation: Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom. Electronic address: davidmdsmith@gmail.com.
authors.forename: David M D
authors.initials: DM
authors.lastname: Smith
authors.affiliation: Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom. Electronic address: Pauline.paterson@lshtm.ac.uk.
authors.forename: Pauline
authors.initials: P
authors.lastname: Paterson
mesh_terms: D002648:Child; D002675:Child, Preschool; D003657:Decision Making; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D014611:Vaccination / Q000523:psychology*; D014612:Vaccines
chemical_list: D014612:Vaccines
keywords: Confidence; Hesitancy; Immunisation; Immunization; Public trust; Vaccine