Vaccine hesitancy refusal and access barriers: The need for clarity in terminology

Thursday, 11th of October 2018 Print

Vaccine hesitancy refusal and access barriers: The need for clarity in terminology

Author links open overlay panel HelenBedfordaKatieAttwellbc1MargieDanchindHelenMarshallePaulCorbenfJulieLeaskg

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  • The term vaccine hesitancy is increasingly used to explain sub-optimal vaccination coverage.


  • The accepted definition includes confidence complacency and convenience.


  • We contend the inclusion of convenience is problematic.


  • Insufficient emphasis is given to the social determinants of vaccination.
  • Accurate terminology is needed for researchers and providers to address under-vaccination.


Although vaccination uptake is high in most countries pockets of sub-optimal coverage remain posing a threat to individual and population immunity. Increasingly the term vaccine hesitancy is being used by experts and commentators to explain sub-optimal vaccination coverage. We contend that using this term to explain all partial or non-immunisation risks generating solutions that are a poor match for the problem in a particular community or population. We propose more precision in the term vaccine hesitancy is needed particularly since much under-vaccination arises from factors related to access or pragmatics. Only with clear terminology can we begin to understand where the problem lies measure it accurately and develop appropriate interventions. This will ensure that our interventions have the best chance of success to make vaccines available to those who want them and in helping those who are uncertain about their vaccination decision.

1Present address: School of Social Science University of Western Australia.

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