Europe
A recent review9 of studies of vaccination attitudes sheds light on survey findings in Europe over the past five years, both regarding the general public and health providers. The research reviewed consisted mainly of surveys and questionnaires, as well as some focus groups, interviews, and experiments, and a set of market research data provided by Vaccines Europe.
This research review found that fear of adverse side effects and vaccine safety were by far the most commonly- cited reasons for vaccine hesitancy among the general public. Strikingly, this was also the most commonly cited reason by healthcare professionals for not getting vaccinated themselves, and was one of the two most common reasons (along with lack of time) that health professionals gave for not vaccinating their patients.
The evidence consolidated by Yaqub et al. builds a strong case that, at least in middle-high income countries, vaccine hesitancy and refusal is not simply an issue of inadequate information or education, but instead a conscious decision among the well-educated where access is also not the dominant barrier.10 The perceived information-related problem was identified more as an issue of trust and confidence in information sources. Perceptions among non-vaccinators included concerns that government decisions about vaccines are over-influenced by vaccine manufacturers.11
Although healthcare providers remain the primary influencing source of information about vaccinations, the research analysed by Yaqub et al. indicates that many European doctors feel that patients today are more sceptical than they were only a few years ago. Friends and family also play a strong role in influencing vaccination decisions. Unsurprisingly, users of “complementary” or “alternative” medicine were significantly more likely to refuse vaccination.12 Doctors themselves reported having too little time to discuss the importance of vaccination with their patients, even when they agreed they had a responsibility to do so.13, 14 Yaqub et al. also observe that doctors who become frustrated with refusing patients sometimes stop providing care to their family, an action unlikely to increase patients’ confidence.