Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: a systematic review of published literature, 2007–2012

HJ Larson, C Jarrett, E Eckersberger, DMD Smith… - Vaccine, 2014 - Elsevier
HJ Larson, C Jarrett, E Eckersberger, DMD Smith, P Paterson
Vaccine, 2014Elsevier
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 …
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.
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