Lancet Child and Adolescent Health: Vaccine hesitancy

12 April, 2019

Dear CHIFA colleagues,

Below are extracts from a new editorial in The Lancet Child and Adolescent Health.


Vaccine hesitancy, which is defined by WHO as a “delay in acceptance or refusal of vaccines despite availability of vaccination services”, has been reported in more than 90% of countries in the world. In many areas, immunisation for measles, a vaccine-preventable disease that was largely eliminated following widespread use of the measles-mumps-rubella (MMR) vaccine, has decreased to less than the 95% threshold set by WHO as that required for herd immunity...

Paediatricians and family doctors have a key role in helping parents appreciate the benefits of vaccination; physicians' advice has been shown to be the most important predictor of vaccine acceptance. All child health workers must promote vaccination — conflicting advice from medical professionals is especially damaging — and must be afforded sufficient time with each family to effectively do so.

A clear presentation of the risks that delaying or refusing vaccination might pose to the child is pivotal to help parents understand how critical their decision is. As Michael Gannon, president of the Australian Medical Association, said, children “are 10 000 times more likely to be brain damaged by measles than […] by vaccination”. In order to support health-care workers, WHO has developed training modules to build capacity in engaging in difficult conversations with hesitant caregivers. Vaccine hesitancy can be difficult for paediatricians to understand, but when interacting with vaccine-hesitant parents, it is important to remember that the health of their children is their primary concern...

Media platforms (including social media) have been enormously influential in the spread of vaccine hesitancy... Kyle Yasuda, president of the American Academy of Paediatrics, contacted the chief executive officers of Google, Facebook, and Pinterest requesting that they partner with the Academy to make sure parents using their platforms are seeing only credible, science-based information. In response, Facebook announced that groups and pages that share anti-vaccine misinformation would be removed from its recommendation algorithm...

Vaccine hesitancy is threatening the historical achievements made in reducing the burden of infectious diseases, which have plagued humanity for centuries. Only a collaborative effort between paediatricians, family doctors, parents, public health officials, governments, the technology sector, and civil society will allow myths and misinformation around vaccination to be dispelled. If we fail, the future health of unvaccinated children and their communities will suffer greatly.


Best wishes, Neil

Coordinator, HIFA Project on Information for Citizens, Parents and Children:

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CHIFA profile: Neil Pakenham-Walsh is the coordinator of the HIFA campaign (Healthcare Information For All) and assistant moderator of the CHIFA forum. Twitter: @hifa_org FB: