Considerations for Vaccine Hesitancy: 3Cs Model

In Canada, about 20% of the population is vaccine hesitant, meaning they have some concerns about vaccination but are not firm vaccine refusers (Dubé et al., 2016). They are distinct from vaccine refusers who make up less than 5% of the population.

According to the World Health Organization (WHO) (2019) vaccine hesitancy is influenced by factors such as: confidence, complacency and, convenience.


Refers to a lack of trust in the effectiveness and safety of vaccines, the system that delivers them – including the reliability of the health professional – and/or the motivations of policy-makers who make determinations about vaccines.


Refers to a low perceived risk of vaccine-preventable diseases and therefore it is assumed vaccines are not needed. Other issues are considered more important.


Refers to the degree to which the comfort, convenience, time, place, and quality of a vaccine affects uptake of the vaccine. This continuum ranges from total acceptance to complete refusal. The concern is that hesitancy can lead to refusal, and unvaccinated clusters may emerge as disease outbreaks (Gangarosa et al., 1998; Jansen et al., 2003).


The success of vaccines means that many parents today have not witnessed the serious consequences of vaccine-preventable diseases like polio, diphtheria, tetanus, and measles. This has led parents to worry more about vaccine adverse effects than the consequences of the diseases themselves. Misinformation on social media and the internet about vaccine ingredients and side-effects may also contribute to lack of vaccine confidence.



Points of Consideration

Some parents believe that natural immunity obtained from illness is better than vaccination, giving rise to a controversial phenomenon referred to as “pox parties.” People use pox parties to deliberately infect their children with chickenpox. Children who catch chickenpox at a pox party will experience the full illness with the hopes to avoid the vaccine. Even in healthy children, there is still a risk of complications which may include skin infections, flesh eating disease, pneumonia, encephalitis, or septicemia. Chickenpox also carries greater risks to newborns, pregnant people, adults, and individuals with weakened immune systems. Complications aside, why expose children to the unpleasant experience of fever, itching, difficulty sleeping, scarring, and missing school?



Icon for the Creative Commons Attribution-ShareAlike 4.0 International License

Vaccine Practice for Health Professionals: 1st Canadian Edition Copyright © by Oona St-Amant; Jennifer Lapum; Vinita Dubey; Karen Beckermann; Che-Sheu Huang; Carly Weeks; Kate Leslie; and Kim English is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License, except where otherwise noted.

Share This Book