Vaccine hesitancy is the reluctance or refusal to vaccinate despite the availability of vaccines (WHO, 2019). The term ‘vaccine hesitancy’ is intentionally used to depolarize antivaccine rhetoric (Larson et al., 2014). Several factors have been cited as contributing to vaccine hesitance including heuristic thinking, the success of vaccination, the perceived unnaturalness of vaccines, the scientific method that can sometimes produce conflicting results, the suspicion of pharmaceuticals or biological materials, the presence of adjuvants in vaccines, and loss of public confidence (Jacobson, Sauver, Rutten, 2015). It is important for health professionals to recognize that given all these factors, there is no singular form of vaccine hesitancy. Instead, it remains a complex and context specific phenomenon that varies across time, place, and vaccine. People who are vaccine hesitant may not refuse all vaccines. They may ask to delay some vaccines or accept vaccines on a different schedule.
Effects of Vaccine Hesitancy
Vaccine hesitancy has been reported in 90% of countries in the world (WHO, 2019). Outbreaks of preventable diseases such as influenza, varicella, pneumococcal disease, measles, and pertussis have been linked to communities with high vaccine refusal rates. In Ontario, vaccine refusal has been linked to resurgences of rubella and measles outbreaks. Even small declines in vaccine coverage rates translate into significant outcomes. An American study found that a 5% reduction in Measles, Mumps, and Rubella (MMR) vaccination in children aged 2-11 led to a three-fold increase in measles cases with an estimated $2.1 million cost to the public healthcare sector (Lo & Hotez, 2017). Dubé and MacDonald (2016) remind health professionals that while vaccine hesitancy is an important public health issue, it should not eclipse the need for continued encouragement and support the majority of people who vaccinate. Video Clip 5.1 is a recreation of a conversation between healthcare providers exhibiting vaccine hesitancy related to the flu shot.
Video Clip 5.1: Conversation on Vaccine Hesitancy among Health Professionals
Shortcuts or quick reactive thinking