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Hum Vaccin Immunother. 2013 Dec;9(12):2643-8. doi: 10.4161/hv.27243. Epub 2013 Nov 18.

Epidemiology of vaccine hesitancy in the United States.

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Emory University; Rollins School of Public Health; Atlanta, GA USA.
Johns Hopkins University; Bloomberg School of Public Health; Baltimore, MD USA.


Vaccines are among the most effective public health interventions against infectious diseases. However, there is evidence in the United States for parents either delaying or refusing recommended childhood vaccination. Exemptions to school immunization laws and use of alternative schedule from those recommended by the Advisory Committee on Immunization Practices and the American Academy of Pediatrics cannot only increase the risk of children contracting vaccine-preventable diseases but also increases the risk of infecting others who are either too young to be vaccinated, cannot be vaccinated for medical reasons or did not develop a sufficient immunological response to the vaccine. Healthcare providers are cited as the most influential source by parents on vaccine decision-making. Vaccine hesitancy needs to be addressed by healthcare providers and the scientific community by listening to the parental concerns and discussing risks associated with either delaying or refusing vaccines.


attitudes; exemptions; immunizations; parent beliefs; vaccine hesitancy; vaccines

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