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Vaccine hesitancy: understand it better, to provide better support

Rather than considering people reluctant to vaccinate as irresponsible, it is better to try to restore confidence by improving public knowledge, identifying the barriers and seeking ways to overcome them.

In France, distrust of vaccines has been on the rise since the 2000s – and probably ever since vaccination itself has existed. This suspicion is believed to be partially to blame for relatively low immunisation coverage for some diseases. It sometimes manifests itself as opposition to any vaccination, but also as a more nuanced set of behaviours under the umbrella term "vaccine hesitancy".

The vaccine decision-making process is complex and multidimensional, often influenced more by personal or family opinions and experiences than by scientific data.

Media coverage of vaccine controversies and health scandals has sown doubts over the usefulness and safety of a particular vaccine. The authorities' poor management of various events (influenza A/H1N1, hepatitis B, Mediator°, etc.) compounded by suspicion of the influence of pharmaceutical companies has also impacted negatively on the public's vaccination adherence.

Health professionals are the preferred source of vaccine information. They have an important role to play in building public trust in the various vaccines. As with other treatments or means of prevention, health professionals need to respond to questions and fears about vaccines' adverse reactions. Health authorities are also key in ensuring a high degree of transparency in vaccine policy decisions. At present, it is unrealistic to expect full public support. It is better to take this fact into account and seek to restore trust by improving knowledge, identifying the barriers and finding ways to overcome them.

©Prescrire 1 May 2019

"Vaccine hesitancy: understand it better, to provide better support" Prescrire Int 2019; 28 (204): 133-137. (Pdf, subscribers only).

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