Vaccine hesitancy is a growing complex and multifaceted phenomenon. It encompasses a wide spectrum of context-dependent attitudes and beliefs. Multiple factors influence parental decision-making including knowledge, sources of information, risk perception, trust, and individual experiences among others. This review focuses on describing the most common reasons that contribute to vaccine hesitancy among parents. Social media and the Internet have been described as major elements that can negatively influence parental decision-making regarding vaccines. The next focus is describing effective interventions that clinical providers can apply. Nonconfrontational and open discussions along with trusting and strong relationships between parents and providers seem to create a solid foundation toward vaccine acceptance. In addition, motivational interviewing is a helpful tool that has proven to be effective during these discussions. Ultimately, an individualized approach tailored to a specific community will likely be most effective in addressing vaccine hesitancy.
The term “vaccine hesitancy” encompasses a wide spectrum of vaccine attitudes and beliefs, which vary from cautious acceptance to complete refusal of vaccinations.
Parents’ opinions about vaccines are influenced by a multitude of individual and contextual factors that need to be acknowledged and understood by providers.
Health care providers remain the most trusted source about vaccines for the general public.
Motivational interviewing is an effective communication tool that can be used to address vaccine hesitancy among parents.
For decades, vaccinations have decreased the burden of infectious diseases and have been described as one of the top 10 greatest public health achievements worldwide [
]. Vaccines have allowed for the eradication of smallpox, the near eradication of polio, and the prevention of over 21 million hospitalizations and 732,000 deaths among children born in the last two decades [ ]. Despite these remarkable achievements, there continues to be a spectrum of parental concerns regarding childhood vaccinations. Unfortunately, this is an increasing trend [ ], and parents consider human papillomavirus and influenza vaccines to be particularly problematic [ ,
]. SARS-CoV-2 vaccination in children is also a controversial topic at this time, which will not be covered in this review.
Parents’ confidence in vaccines is critical to the success of national immunization programs [
]. However, vaccines can be a victim of their own success as the visibility of vaccine-preventable diseases (VPDs) is dramatically reduced [ ]. Children who are not vaccinated due to parental refusal remain at increased risk of acquiring VPDs which can subsequently contribute to outbreaks [ ], as has been noted with measles and pertussis over the last several years [
Additionally, parents are more often requesting exemptions to school entry requirements for vaccination, and providers perceive parental vaccine refusal as being more common [
]. It has been estimated that 13% to 27% of parents of young children delay recommended vaccinations and 6% to 16% decline recommended vaccinations in the United States [
The term “vaccine hesitancy” helps identify and define individual’s concerns surrounding vaccination [
, ]. In this review, we discuss important aspects about general vaccine hesitancy regarding routine pediatric immunizations. We also provide strategies that health care professionals can use to address it in pediatric clinical practice.