Per the Kentucky Respiratory Disease Dashboard, there is a continuous increase in hospitalizations and Emergency Department visits related to COVID-19, influenza, and RSV at the same time vaccination rates indicate growing vaccine hesitancy (Workbook: DPH RSP 001 Respiratory Diseases (ky.gov)). A recent Health Alert Network (HAN) Health Advisory from the CDC highlights alarmingly low vaccination rates for COVID-19, influenza, and RSV. The coverage for the seasonal 2023-2024 influenza vaccine has notably decreased across all age groups compared to the previous season, with only 43.8% of individuals aged 18 and above and 43.9% of children aged 6 months to 17 years having received the flu vaccine, as reported on the CDC weekly flu vaccination dashboard as of December 23, 2023.
The statistics for COVID-19 vaccination are even more concerning with only 7.7% of children aged 6 months to 17 years and 18.2% of adults aged 18 and above reported as up to date with the updated 2023-2024 COVID-19 vaccine. In response to this situation, healthcare providers are urged to actively encourage all eligible individuals to get vaccinated.
Recognizing and addressing the reasons behind individual hesitancy toward receiving vaccinations for influenza, COVID-19 and RSV is crucial. This hesitancy has been noted to be multifactorial. In a recent systemic review done by Kafadar et.al (2023), specifically around COVID-19 vaccine hesitancy, factors such as age, sex, race, trust of the healthcare system, understanding of severity of COVID-19 and vaccine effectiveness all played a potential role in hesitancy to receive the COVID-9 vaccine. Understanding and acknowledging these diverse influences are critical for tailoring effective strategies to address vaccine hesitancy comprehensively.
Common reasons why vaccine hesitancy occurs
Vaccine hesitancy refers to a delay in acceptance of vaccines, or an outright refusal of vaccination despite the availability of vaccination services. It can manifest at both individual and community levels and is influenced by a variety of factors.
Misinformation and Lack of Information: Incorrect or misleading information about vaccines can contribute to hesitancy. This misinformation may be spread through social media, websites, or other sources, leading individuals to doubt the safety and efficacy of vaccines.
Distrust in Authorities: Some people may not trust government health agencies, pharmaceutical companies, or healthcare providers. Historical events, such as unethical medical practices or past vaccine controversies, can contribute to a general mistrust in the healthcare system. When the government is involved in the promotion of vaccines, such as was evident during the COVID-19 pandemic, this already existing distrust and suspicion, can affect the acceptance of the vaccine.
Fear of Side Effects: Concerns about potential side effects, whether real or perceived, can contribute to vaccine hesitancy. The fear of adverse reactions may be fueled by anecdotes, media coverage, or misconceptions about vaccine safety.
Complacency: In situations where a disease is rare or perceived as not severe, individuals may feel that vaccination is unnecessary. This complacency can lead to a decreased sense of urgency to get vaccinated.
Religious or Philosophical Beliefs: Some individuals may have religious or philosophical objections to vaccination. These beliefs may be deeply rooted in personal values, cultural practices, or a general mistrust of medical interventions.
Access Barriers: Limited access to healthcare services, including vaccines, can contribute to hesitancy. This may include issues such as lack of transportation, financial constraints, or living in remote areas with limited healthcare infrastructure. In many underserved and highly minority populated areas, there are lower life expectancy rates when compared to those of their counterparts who live in more resource rich and safer surroundings. This is in part due to the lack of access to care.
Social and Peer Influences: The opinions and decisions of friends, family, and community members can strongly influence an individual’s choice to get vaccinated. Peer pressure, as well as the desire to conform to social norms, may play a role.
Political or Ideological Factors: Vaccine hesitancy can sometimes be associated with political or ideological beliefs. Opposition to vaccination may align with certain political or philosophical ideologies, contributing to resistance against immunization. There is a heavy influence within religious organizations that depend heavily on the actions and opinions of the clergy or other leaders.
Addressing vaccine hesitancy to prevent disease outbreaks
It is safe to say, addressing vaccine hesitancy requires a multifaceted approach. These include involving education, clear communication, building trust in healthcare systems, and addressing the specific concerns of different communities. Public health campaigns, community engagement, and open dialogue with healthcare providers play crucial roles in promoting vaccine acceptance and improving overall immunization rates.
The CDC has embarked on a campaign titled Vaccinate with Confidence. The CDC states, “Vaccinate with Confidence is CDC’s strategic framework to strengthen vaccine confidence and prevent outbreaks of vaccine-preventable diseases in the United States” (CDC, 2019).
The three main objectives of Vaccinate with Confidence are outlined as:
- Protect Communities
- Empower Families
- Stop Myths
Vaccinate with Confidence combines CDC’s existing work with new investment, partnerships, and activities to protect communities at risk and strengthen public trust in the life-saving protection of vaccines (CDC, 2019).
Read more about the CDC’s approach to fight against vaccine hesitancy.