Send to

Choose Destination
Vaccine. 2018 Oct 22;36(44):6556-6558. doi: 10.1016/j.vaccine.2017.08.004. Epub 2017 Aug 19.

Vaccine hesitancy, refusal and access barriers: The need for clarity in terminology.

Author information

Faculty of Population Health Sciences, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, United Kingdom. Electronic address:
Sir Walter Murdoch School of Public Policy and International Affairs, Murdoch University, Murdoch, WA 6150, Australia; Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Western Australia, Australia. Electronic address:
Murdoch Children's Research Institute, Flemington Road, Parkville, Victoria 3052, Australia.
Robinson Research Institute and Adelaide Medical School, University of Adelaide and Women's and Children's Health Network, Adelaide, South Australia 5006, Australia.
North Coast Public Health Unit, Port Macquarie Community Health Campus, PO Box 126, Port Macquarie, NSW 2444, Australia.
Sydney Nursing School, University of Sydney, 88 Mallett St, Camperdown, NSW 2006, Australia.


Although vaccination uptake is high in most countries, pockets of sub-optimal coverage remain posing a threat to individual and population immunity. Increasingly, the term 'vaccine hesitancy' is being used by experts and commentators to explain sub-optimal vaccination coverage. We contend that using this term to explain all partial or non-immunisation risks generating solutions that are a poor match for the problem in a particular community or population. We propose more precision in the term 'vaccine hesitancy' is needed particularly since much under-vaccination arises from factors related to access or pragmatics. Only with clear terminology can we begin to understand where the problem lies, measure it accurately and develop appropriate interventions. This will ensure that our interventions have the best chance of success to make vaccines available to those who want them and in helping those who are uncertain about their vaccination decision.


Immunisation; Vaccination hesitancy; Vaccine hesitancy

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center