title: Vaccine hesitancy: understanding better to address better.
abstract: Vaccine hesitancy is an emerging term in the socio-medical literature which describes an approach to vaccine decision making. It recognizes that there is a continuum between full acceptance and outright refusal of some or all vaccines and challenges the previous understanding of individuals or groups, as being either anti-vaccine or pro-vaccine. The behaviours responsible for vaccine hesitancy can be related to confidence, convenience and complacency. The causes of vaccine hesitancy can be described by the epidemiological triad i.e. the complex interaction of environmental- (i.e. external), agent- (i.e. vaccine) and host (or parent)- specific factors. Vaccine hesitancy is a complex and dynamic issue; future vaccination programs need to reflect and address these context-specific factors in both their design and evaluation. Many experts are of the view that it is best to counter vaccine hesitancy at the population level. They believe that it can be done by introducing more transparency into policy decision-making before immunization programs, providing up-to-date information to the public and health providers about the rigorous procedures undertaken before introduction of new vaccines, and through diversified post-marketing surveillance of vaccine-related events.
authors.affiliation: Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Basni-II, Jodhpur, Rajasthan 342005 India.
authors.forename: Dewesh
authors.initials: D
authors.lastname: Kumar
authors.affiliation: Department of Community Medicine, Rohilkhand Medical College and Hospital, Bareilly, U.P, 243006 India.
authors.forename: Rahul
authors.initials: R
authors.lastname: Chandra
authors.affiliation: Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Basni-II, Jodhpur, Rajasthan 342005 India.
authors.forename: Medha
authors.initials: M
authors.lastname: Mathur
authors.affiliation: Department of Radiation Oncology, All India Institute of Medical Sciences, Basni-II, Jodhpur, Rajasthan 342005 India.
authors.forename: Saurabh
authors.initials: S
authors.lastname: Samdariya
authors.affiliation: RMNCH + A Scale up project, IPE Global/USAID, Sixth Floor, DSHM, B block, Vikas Bhawan-2, Civil Lines, New Delhi, 110054 India.
authors.forename: Neelesh
authors.initials: N
authors.lastname: Kapoor
keywords: Vaccination; Vaccine confidence; Vaccine decision making; Vaccine hesitancy
references.citation: Curr Probl Pediatr Adolesc Health Care. 2010 Mar;40(3):38-58
references.pmid: 20230978
references.citation: Pediatr Infect Dis J. 2005 Nov;24(11):953-61
references.pmid: 16282928
references.citation: Vaccine. 2007 Nov 7;25(45):7818-23
references.pmid: 17920170
references.citation: Vaccine. 1998 Nov;16 Suppl:S73-5
references.pmid: 9915043
references.citation: N Engl J Med. 2009 May 7;360(19):1981-8
references.pmid: 19420367
references.citation: Public Health Rep. 2011 Jul-Aug;126 Suppl 2:135-46
references.pmid: 21812176
references.citation: Hum Vaccin Immunother. 2013 Aug;9(8):1763-73
references.pmid: 23584253
references.citation: J Clin Epidemiol. 2005 Nov;58(11):1081-8
references.pmid: 16223649
references.citation: JAMA. 2002 Jun 26;287(24):3245-8
references.pmid: 12076221
references.citation: Am J Health Behav. 2005 Jan-Feb;29(1):81-92
references.pmid: 15604052
references.citation: Pediatrics. 2005 Nov;116(5):e623-33
references.pmid: 16263976
references.citation: Arch Dis Child. 2010 Aug;95(8):580-2
references.pmid: 20371593
references.citation: Lancet. 1998 Jan 31;351(9099):356-61
references.pmid: 9652634
references.citation: Milbank Q. 1994;72(2):225-58
references.pmid: 8007898
references.citation: Prim Care. 2011 Dec;38(4):717-28, ix
references.pmid: 22094142
references.citation: Eur J Public Health. 2009 Jan;19(1):2-4
references.pmid: 19158101
references.citation: Vaccine. 2014 Apr 17;32(19):2150-9
references.pmid: 24598724
references.citation: Vaccine. 2009 Jun 19;27(30):3935-44
references.pmid: 19467744
references.citation: Euro Surveill. 2014 Feb 20;19(7):20703
references.pmid: 24576475
references.citation: Pediatrics. 2011 May;127 Suppl 1:S127-33
references.pmid: 21502238
references.citation: Pediatrics. 2015 Jul;136(1):70-9
references.pmid: 26034240
references.citation: Vaccine. 2012 May 28;30(25):3778-89
references.pmid: 22172504
references.citation: Hum Vaccin Immunother. 2013 Aug;9(8):1755-62
references.pmid: 23744504
references.citation: Public Health Rep. 2005 May-Jun;120(3):252-8
references.pmid: 16134564
references.citation: Health Aff (Millwood). 2011 Jun;30(6):1151-9
references.pmid: 21653969
references.citation: J Med Internet Res. 2005 Jun 29;7(2):e17
references.pmid: 15998608
references.citation: Curr Med Res Opin. 2008 Jun;24(6):1719-41
references.pmid: 18474148
references.citation: Health Educ Res. 2012 Dec;27(6):1069-80
references.pmid: 22907535
references.citation: Am J Infect Control. 2009 Sep;37(7):551-6
references.pmid: 19556035
references.citation: Vaccine. 2012 May 28;30(25):3734-40
references.pmid: 22178516
references.citation: Vaccine. 1998 Nov;16 Suppl:S93-8
references.pmid: 9915047
references.citation: J Epidemiol Community Health. 2000 Jun;54(6):473-4
references.pmid: 10818125
references.citation: Public Health Rep. 2011 Jul-Aug;126 Suppl 2:13-23
references.pmid: 21812165
references.citation: J Pediatr Health Care. 2015 Jul-Aug;29(4):385-94
references.pmid: 26096835
references.citation: Soc Sci Med. 1999 Dec;49(12):1705-16
references.pmid: 10574240
references.citation: Vaccine. 2005 Mar 31;23(19):2486-93
references.pmid: 15752835
references.citation: BMC Pediatr. 2012 Sep 21;12:154
references.pmid: 22998654
references.citation: Hum Vaccin Immunother. 2012 Sep;8(9):1272-82
references.pmid: 22894959
references.citation: Lancet. 1994 Sep 3;344(8923):665-70
references.pmid: 7915354
references.citation: Sociol Health Illn. 2007 Mar;29(2):198-215
references.pmid: 17381813
references.citation: Pediatrics. 2008 Oct;122(4):718-25
references.pmid: 18829793
references.citation: Vaccine. 2010 Aug 9;28(35):5731-7
references.pmid: 20558250
references.citation: Vaccine. 2015 Aug 14;33(34):4204-11
references.pmid: 25900132
references.citation: Lancet. 2010 Mar 20;375(9719):970-1
references.pmid: 20333812
references.citation: Vaccine. 2001 Oct 15;20 Suppl 1:S16-9; discussion S1
references.pmid: 11587803
references.citation: Pediatrics. 2006 May;117(5):1532-41
references.pmid: 16651306
references.citation: J Dev Behav Pediatr. 2005 Dec;26(6):441-52
references.pmid: 16344662
references.citation: PLoS Curr. 2015 Feb 25;7:null
references.pmid: 25789200
references.citation: J Glob Health. 2011 Jun;1(1):32-5
references.pmid: 23198099
references.citation: Matern Child Health J. 2008 Nov;12(6):766-73
references.pmid: 17987370
references.citation: MMWR Morb Mortal Wkly Rep. 1999 Apr 2;48(12):241-3
references.pmid: 10220250
references.citation: Pediatrics. 2011 May;127 Suppl 1:S92-9
references.pmid: 21502253
references.citation: J Health Psychol. 2010 Apr;15(3):446-55
references.pmid: 20348365
references.citation: Vaccine. 2010 Feb 17;28(7):1709-16
references.pmid: 20045099