Vaccine hesitancy and risk communication

Overview & Definition

You are in a six-week check. The baby is well. The parent says, "We are not anti-vaccine — we just want to wait a bit." That sentence is the clinical problem this page is built for. It is not a debate club. It is a preventive consultation with a child who still needs protection, a family who still needs a relationship with you, and a schedule that still has a clock.[1]

Vaccine hesitancy is delay in acceptance or refusal of vaccines despite availability of vaccination services. The SAGE Working Group definition matters because it separates attitude from access. A family who cannot get an appointment is not the same clinical problem as a family who can but will not.[1][3]

Think of hesitancy as a continuum, not a binary. At one end sit confident acceptors. In the middle sit parents with specific questions, selective delays, or requests to "spread out" antigens. At the far end sit firm refusals. People move along that line after a fever, a news story, a trusted relative, or a good conversation with you.[1][2]

Risk communication here has four practical aims:[5]

1. Help the caregiver see disease risk and vaccine risk in proportion.
2. Support an informed decision without bullying.
3. Preserve trust so the child can return.
4. Where clinically appropriate, improve on-time uptake.[5][6]

[13]

Full antigen schedules, catch-up tables, and true contraindications live on sibling pages. This leaf owns the conversation, assessment of determinants, and ethical plan.[1]

References18Show ledgerHide ledger

1. [1]MacDonald NE Vaccine hesitancy: Definition, scope and determinants. Vaccine, 2015.PMID 25896383
2. [2]Larson HJ, Jarrett C Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: a systematic review of published literature, 2007-2012. Vaccine, 2014.PMID 24598724
3. [3]Dubé E, Laberge C Vaccine hesitancy: an overview. Human vaccines & immunotherapeutics, 2013.PMID 23584253
4. [4]Larson HJ, Jarrett C Measuring vaccine hesitancy: The development of a survey tool. Vaccine, 2015.PMID 25896384
5. [5]Goldstein S, MacDonald NE Health communication and vaccine hesitancy. Vaccine, 2015.PMID 25896382
6. [6]Eskola J, Duclos P How to deal with vaccine hesitancy? Vaccine, 2015.PMID 25896378
7. [7]Opel DJ, Mangione-Smith R The Influence of Provider Communication Behaviors on Parental Vaccine Acceptance and Visit Experience. American journal of public health, 2015.PMID 25790386
8. [8]Opel DJ, Zhou C Impact of Childhood Vaccine Discussion Format Over Time on Immunization Status. Academic pediatrics, 2018.PMID 29325912
9. [9]Nyhan B, Reifler J Effective messages in vaccine promotion: a randomized trial. Pediatrics, 2014.PMID 24590751
10. [10]Betsch C, Renkewitz F The influence of vaccine-critical websites on perceiving vaccination risks. Journal of health psychology, 2010.PMID 20348365
11. [11]Brewer NT, Chapman GB Increasing Vaccination: Putting Psychological Science Into Action. Psychological science in the public interest : a journal of the American Psychological Society, 2017.PMID 29611455
12. [12]Opel DJ, Mangione-Smith R Development of a survey to identify vaccine-hesitant parents: the parent attitudes about childhood vaccines survey. Human vaccines, 2011.PMID 21389777
13. [13]Diekema DS Responding to parental refusals of immunization of children. Pediatrics, 2005.PMID 15867060
14. [14]Healy CM, Montesinos DP Parent and provider perspectives on immunization: are providers overestimating parental concerns? Vaccine, 2014.PMID 24315883
15. [15]Gagneur A, Gutnick D From vaccine hesitancy to vaccine motivation: A motivational interviewing based approach to vaccine counselling. Human vaccines & immunotherapeutics, 2024.PMID 39187772
16. [16]Verger P, Cogordan C A postpartum intervention for vaccination promotion by midwives using motivational interviews reduces mothers' vaccine hesitancy, south-eastern France, 2021 to 2022: a randomised controlled trial. Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin, 2023.PMID 37733238
17. [17]McDonald C, Leask J A Consent Support Resource with Benefits and Harms of Vaccination Does Not Increase Hesitancy in Parents-An Acceptability Study. Vaccines, 2020.PMID 32887503
18. [18]Hofstetter AM, Robinson JD Clinician-parent discussions about influenza vaccination of children and their association with vaccine acceptance. Vaccine, 2017.PMID 28392141