Elsevier

The Journal of Pediatrics

Volume 175, August 2016, Pages 248-249.e1
The Journal of Pediatrics

European Paediatric Association Pages
Vaccine Hesitancy and Refusal

https://doi.org/10.1016/j.jpeds.2016.06.006Get rights and content

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Definition and Effects of Vaccine Hesitancy and Refusal Phenomenon

Vaccine hesitancy and refusal has developed most likely because of multiple social, cultural, political, and personal converging factors.1 There is blurring between hesitancy and refusal; inconsistencies also exist in the definition when the problem is mapped in different countries.4

The World Health Organization defines vaccine hesitancy and refusal as a delay in acceptance or refusal of vaccines despite availability of vaccination services. Vaccine hesitancy was described to be complex and

Political and Social Aspects

Different circumstances in Europe have influenced vaccine coverage and rendered Europe prone to vaccine failure and hesitancy. Political conflicts and instability, as well as immigration, have been linked to vaccine hesitancy. For example, concerns have been raised about the suspected use of porcine components in vaccines.9 Several Central and Eastern European countries have experienced decreasing vaccine uptake and delayed vaccinations following the fall of Soviet Union, and some of these

Ethics

It is not necessary to delve too far into the past to sense a disinclination to vaccinate, given the widely held false perception that vaccine-preventable diseases are no longer a threat. A reliance (and belief) in herd protection bolsters the perceived rights of parents and other individuals not to vaccinate and for them to rely on others being vaccinated. This is not to argue that it would be “good” for a few cases of subacute sclerosing panencephalitis following measles or congenital rubella

Consequences

It is now nearly 20 years since the infamous article by Wakefield et al,11 fraudulently purporting to have shown a link between measles/mumps/rubella vaccine and autism. There are likely to be cohorts, now reaching young adulthood, who are neither vaccinated against these 3 viruses nor exposed naturally. Ironically, their chances of exposure to measles are not negligible because of the high transmissibility of this virus and recurrent measles epidemics.12 The chance of female members of these

Conclusions

In terms of numbers of lives saved, vaccination stands among the most effective measures ever accomplished by medical intervention.15 However, the results achieved by this public health intervention are seriously endangered by the growing phenomena of vaccine hesitancy and refusal. The multifactorial and complex causes of vaccine hesitancy, including the uncompromised demand for the unremitting usage of vaccines, their coincidental temporal relationships to adverse health outcomes,

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E.M. is employed by Takeda Vaccines. The other authors declare no conflicts of interest.

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