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What is Vaccine Hesitancy?

This article explores one of the barriers to vaccine uptake - hesitancy

The World Health Organisation has declared vaccine hesitancy a major threat to global health which threatens to reverse the progress that has been made in vaccine-preventable diseases.

Vaccine hesitancy is a delay in acceptance or refusal of vaccines despite the availability of immunisation services. Vaccine hesitancy is believed to be the leading cause of declining immunisation rates in high income regions such as Europe and North America.

The reasons for vaccine hesitancy are complex but are summarised in the diagram below, which is taken from a report by the SAGE working group on vaccine hesitancy:

a model of vaccine hesitancy. Three circles overlap in the centre. circle one:complacency, circle two: confidence, circle three: convenience Image: A Model of Vaccine Hesitancy

The model in the image above is referred to as the 3Cs models, it illustrates key factors associated with vaccine hesitancy.


The low prevalence of vaccine preventable diseases (due to the success of vaccination) means that the risks associated with infectious diseases are perceived by some as being low, therefore the reasons for vaccination are not apparent.


For some, vaccine hesitancy is due to a lack of trust in the safety or effectiveness of vaccines or institutions that recommend vaccination. The root causes of this issue are complex but in part relate to the circulation of misinformation on social media, beliefs held within specific communities and suspicion of vaccination workers.


The availability and affordability of vaccines is an important aspect of vaccine implementation that we discussed in week 1. The broader issues surrounding vaccine availability that may lead to vaccine hesitancy include the ability to understand (language and health literacy), the perceived quality of the service and the cultural context of what is considered convenient and comfortable.

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The Role of Vaccines in Preventing Infectious Diseases and Antimicrobial Resistance

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