Vaccine hesitancy is receiving increasing public health attention in developed and developing countries around the world. Public health authorities can have an impact on vaccine acceptance, vaccination coverage and delay in receipt of vaccines within the general public. This review of published reviews and Canadian interventional studies aims to identify evidence-based best practices and areas for future research, to inform the development of action and research plans.
Recent reviews (n=9) and interventional studies conducted in Canada (n=10) showed that there is no strong evidence on which type of intervention to recommend to address vaccine hesitancy/refusal. Findings of this review indicate that some types of interventions showed more promising effect on vaccine acceptance and vaccine uptake (e. g. tools such as reminders and recall for patients and healthcare providers). However, it remains unclear whether educational initiatives alone alter vaccine refusal and hesitancy. Multifaceted interventions (encompassing improved access to vaccines, immunization mandates, and patient education) may increase vaccine uptake in vaccine-hesitant populations.
Some recent reviews of the literature have looked at communication strategies with parents and at the influence of these strategies on parents’ decisions regarding childhood vaccination. Overall, findings showed that healthcare providers play a key role in patient/parent vaccination decision-making and are perceived as an important source of vaccination information. Poor communication or negative relationships with healthcare providers sometimes have an impact on parents’ vaccination decisions. Building parental trust seems to be an important component of the provider-parent interaction.
Key principles for optimizing strategies to address vaccine hesitancy were identified. To be effective, interventions should be developed using a planning framework and should be based on a theoretical model. The use of a combination of different interventions (multiple components) appears to be more effective than single-component interventions. Interventions are most likely to succeed when they are based on empirical data and situational assessment – both to have a detailed level of understanding of the vaccine hesitancy situation (susceptible populations, key determinants of vaccination, barriers and enabling conditions, etc.) and to properly evaluate the impact of the intervention.