Countering Vaccine Hesitancy
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This Clinical Report was revised. See https://doi.org/10.1542/peds.2023-065483.: Immunizations have led to a significant decrease in rates of vaccine-preventable diseases and have made a significant impact on the health of children. However, some parents express concerns about vaccine safety and the necessity of vaccines. The concerns of parents range from hesitancy about some immunizations to refusal of all vaccines. This clinical report provides information about addressing parental concerns about vaccination.
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Vaccine hesitancy has remained a long-term concern of pediatricians and public health workers.
“Vaccine hesitancy has remained a long-term concern of pediatricians and public health workers.47”
From SARS-CoV-2 vaccine testing and trials in the pediatric population: biologic, ethical, research, and implementation challenges (2021) · cites this paper as [47]
Cites
Larson, H. J., Jarrett, C., Eckersberger, E., Smith, D. M. D., & Paterson, P. (2014) · Vaccine · doi:10.1016/j.vaccine.2014.01.081 · Cited by 2,254 · see citing works
Effective messages in vaccine promotion: a randomized trial
Nyhan, B., Reifler, J., Richey, S., & Freed, G. L. (2014) · Pediatrics · doi:10.1542/peds.2013-2365 · Cited by 1,300 · see citing works
Vaccine Refusal, Mandatory Immunization, and the Risks of Vaccine-Preventable Diseases
Omer, S. B., Salmon, D. A., Orenstein, W. A., deHart, M. P., & Halsey, N. A. (2009) · New England Journal of Medicine · doi:10.1056/nejmsa0806477 · Cited by 999 · see citing works
Association Between Vaccine Refusal and Vaccine-Preventable Diseases in the United States
Phadke, V. K., Bednarczyk, R. A., Salmon, D. A., & Omer, S. B. (2016) · JAMA · doi:10.1001/jama.2016.1353 · Cited by 677 · see citing works
Communicating with parents about vaccination: a framework for health professionals
Leask, J., Kinnersley, P., Jackson, C., Cheater, F., Bedford, H. E., & Rowles, G. (2012) · BMC Pediatrics · doi:10.1186/1471-2431-12-154 · Cited by 654 · see citing works
Parents With Doubts About Vaccines: Which Vaccines and Reasons Why
Gust, D. A., Darling, N., Kennedy, A., & Schwartz, B. (2008) · PEDIATRICS · doi:10.1542/peds.2007-0538 · Cited by 611 · see citing works
Qualitative analysis of mothers’ decision-making about vaccines for infants: the importance of trust
Benin, A. L., Wisler-Scher, D. J., Colson, E., Shapiro, E. D., & Holmboe, E. S. (2006) · Pediatrics · doi:10.1542/peds.2005-1728 · Cited by 608 · see citing works
Salathé, M., & Khandelwal, S. (2011) · PLoS Computational Biology · doi:10.1371/journal.pcbi.1002199 · Cited by 530 · see citing works
Factors Associated With Refusal of Childhood Vaccines Among Parents of School-aged Children
Salmon, D. A., Moulton, L. H., Omer, S. B., deHart, M. P., Stokley, S. K., & Halsey, N. A. (2005) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpedi.159.5.470 · Cited by 514 · see citing works
The Architecture of Provider-Parent Vaccine Discussions at Health Supervision Visits
Opel, D. J., Heritage, J., Taylor, J. A., Mangione-Smith, R., Salas, H. S., DeVere, V., Zhou, C., & Robinson, J. D. (2013) · Pediatrics · doi:10.1542/peds.2013-2037 · Cited by 507 · see citing works
Anti-vaccinationists past and present
Wolfe, R. M., & Sharp, L. K. (2002) · BMJ · doi:10.1136/bmj.325.7361.430 · Cited by 505 · see citing works
Parental vaccine safety concerns in 2009
Freed, G. L., Clark, S. J., Butchart, A. T., Singer, D. C., & Davis, M. M. (2010) · PEDIATRICS · doi:10.1542/peds.2009-1962 · Cited by 503 · see citing works
The Vaccine Adverse Event Reporting System (VAERS)
CHEN, R., RASTOGI, S., MULLEN, J., HAYES, S., COCHI, S., DONLON, J., & WASSILAK, S. (1994) · Vaccine · doi:10.1016/0264-410x(94)90315-8 · Cited by 498 · see citing works
Smith, P. J., Humiston, S. G., Marcuse, E. K., Zhao, Z., Dorell, C., Howes, C., & Hibbs, B. F. (2011) · Public Health Reports · doi:10.1177/00333549111260s215 · Cited by 462 · see citing works
Children Who Have Received No Vaccines: Who Are They and Where Do They Live?
Smith, P. J., Chu, S. Y., & Barker, L. E. (2004) · PEDIATRICS · doi:10.1542/peds.114.1.187 · Cited by 442 · see citing works
Feikin, D. R. (2000) · JAMA · doi:10.1001/jama.284.24.3145 · Cited by 439 · see citing works
A systematic review of interventions for reducing parental vaccine refusal and vaccine hesitancy
Sadaf, A., Richards, J. L., Glanz, J. M., Salmon, D. A., & Omer, S. B. (2013) · Vaccine · doi:10.1016/j.vaccine.2013.07.013 · Cited by 392 · see citing works
The Vaccine Adverse Event Reporting System (VAERS)
(1994) · Vaccine · doi:10.1016/0264-410x(94)90044-2 · Cited by 392 · see citing works
Smith, P. J., Kennedy, A., Wooten, K. G., Gust, D. A., & Pickering, L. K. (2006) · PEDIATRICS · doi:10.1542/peds.2006-0923 · Cited by 378 · see citing works
Addressing parents’ concerns: do multiple vaccines overwhelm or weaken the infant's immune system?
Offit, P. A., Quarles, J., Gerber, M. A., Hackett, C. J., Marcuse, E. K., Kollman, T. R., Gellin, B. G., & Landry, S. (2002) · Pediatrics · doi:10.1542/peds.109.1.124 · Cited by 312 · see citing works
Timeliness of Childhood Vaccinations in the United States
Luman, E. T., Barker, L. E., Shaw, K. M., McCauley, M. M., Buehler, J. W., & Pickering, L. K. (2005) · JAMA · doi:10.1001/jama.293.10.1204 · Cited by 298 · see citing works
Reducing the pain of childhood vaccination: an evidence-based clinical practice guideline (summary)
Taddio, A., Appleton, M., Bortolussi, R. A., Chambers, C. T., Dubey, V., Halperin, S. A., Hanrahan, A., Ipp, M., Lockett, D., MacDonald, N. E., et al. (2010) · Canadian Medical Association Journal · doi:10.1503/cmaj.092048 · Cited by 295 · see citing works
Responding to Parental Refusals of Immunization of Children
Diekema, D. S. (2005) · PEDIATRICS · doi:10.1542/peds.2005-0316 · Cited by 294 · see citing works
Kennedy, A., Basket, M. M., & Sheedy, K. (2011) · PEDIATRICS · doi:10.1542/peds.2010-1722n · Cited by 280 · see citing works
What the World's religions teach, applied to vaccines and immune globulins
Grabenstein, J. D. (2013) · Vaccine · doi:10.1016/j.vaccine.2013.02.026 · Cited by 270 · see citing works
The Vaccine Safety Datalink: successes and challenges monitoring vaccine safety
McNeil, M. M., Gee, J. M., Weintraub, E., Belongia, E. A., Lee, G. M., Glanz, J. M., Nordin, J. D., Klein, N. P., Baxter, R. P., Naleway, A. L., et al. (2014) · Vaccine · doi:10.1016/j.vaccine.2014.07.073 · Cited by 247 · see citing works
Safety of Vaccines Used for Routine Immunization of US Children: A Systematic Review
Maglione, M., Das, L., Raaen, L. B., Smith, A. C., Chari, R., Newberry, S. J., Shanman, R., Perry, T., Goetz, M. B., & Gidengil, C. A. (2014) · PEDIATRICS · doi:10.1542/peds.2014-1079 · Cited by 239 · see citing works
Alternative Vaccination Schedule Preferences Among Parents of Young Children
Dempsey, A. F., Schaffer, S. E., Singer, D., Butchart, A. T., Davis, M. M., & Freed, G. L. (2011) · PEDIATRICS · doi:10.1542/peds.2011-0400 · Cited by 229 · see citing works
Vaccination Policies and Rates of Exemption from Immunization, 2005–2011
Omer, S. B., Richards, J. L., Ward, M., & Bednarczyk, R. A. (2012) · New England Journal of Medicine · doi:10.1056/nejmc1209037 · Cited by 224 · see citing works
Sexual Activity–Related Outcomes After Human Papillomavirus Vaccination of 11- to 12-Year-Olds
Bednarczyk, R. A., Davis, R. L., Ault, K. A., Orenstein, W. A., & Omer, S. B. (2012) · PEDIATRICS · doi:10.1542/peds.2012-1516 · Cited by 211 · see citing works
Immunization Attitudes and Beliefs Among Parents: Beyond a Dichotomous Perspective
Gust, D. A., Brown, C. J., Sheedy, K., Hibbs, B. F., Weaver, D. L., & Nowak, G. J. (2005) · American Journal of Health Behavior · doi:10.5993/ajhb.29.1.7 · Cited by 205 · see citing works
Prevalence of Parental Concerns About Childhood Vaccines
Kempe, A., Daley, M. F., McCauley, M. M., Crane, L. A., Suh, C. A., Kennedy, A., Basket, M. M., Stokley, S. K., Dong, F., Babbel, C. I., et al. (2011) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2010.12.025 · Cited by 184 · see citing works
Measles—United States, January 1–April 25, 2008
Clemmons, N. S., Gastañaduy, P. A., Fiebelkorn, A. P., Redd, S. B., & Wallace, G. S. (2008) · JAMA · doi:10.1001/jama.299.22.2621 · Cited by 182 · see citing works
How to Communicate With Vaccine-Hesitant Parents
Healy, C. M., & Pickering, L. K. (2011) · PEDIATRICS · doi:10.1542/peds.2010-1722s · Cited by 182 · see citing works
Reasons for Not Vaccinating Adolescents: National Immunization Survey of Teens, 2008–2010
Darden, P. M., Thompson, D. M., Roberts, J. R., et al. (2013) · PEDIATRICS · doi:10.1542/peds.2012-2384 · Cited by 179 · see citing works
Vaccine Delays, Refusals, and Patient Dismissals: A Survey of Pediatricians
Hough-Telford, C., Kimberlin, D. W., Aban, I., Hitchcock, W. P., Almquist, J. R., Kratz, R., & O’Connor, K. G. (2016) · PEDIATRICS · doi:10.1542/peds.2016-2127 · Cited by 177 · see citing works
Vaccine Beliefs of Parents Who Oppose Compulsory Vaccination
Kennedy, A., Brown, C. J., & Gust, D. A. (2005) · Public Health Reports · doi:10.1177/003335490512000306 · Cited by 175 · see citing works
“Nature Does Things Well, Why Should We Interfere?”: Vaccine Hesitancy Among Mothers
Dubé, E., Vivion, M., Sauvageau, C., Gagneur, A., Gagnon, R., & Guay, M. (2016) · Qualitative Health Research · doi:10.1177/1049732315573207 · Cited by 170 · see citing works
Nonmedical Exemptions From School Immunization Requirements: A Systematic Review
Wang, E., Clymer, J. R., Davis-Hayes, C., & Buttenheim, A. M. (2014) · American Journal of Public Health · doi:10.2105/ajph.2014.302190 · Cited by 160 · see citing works
Physician Communication Training and Parental Vaccine Hesitancy: A Randomized Trial
Henrikson, N. B., Opel, D. J., Grothaus, L. C., Nelson, J. C., Scrol, A., Dunn, J., Faubion, T., Roberts, M., Marcuse, E. K., & Grossman, D. C. (2015) · PEDIATRICS · doi:10.1542/peds.2014-3199 · Cited by 152 · see citing works
Taylor, J. A., Darden, P. M., Slora, E. J., et al. (1997) · PEDIATRICS · doi:10.1542/peds.99.2.209 · Cited by 145 · see citing works
‘Clustering of exemptions’ as a collective action threat to herd immunity
May, T., & Silverman, R. D. (2003) · Vaccine · doi:10.1016/s0264-410x(02)00627-8 · Cited by 120 · see citing works
Identification and characteristics of vaccine refusers
Wei, F., Mullooly, J. P., Goodman, M., McCarty, M. C., Hanson, A. M., Crane, B., & Nordin, J. D. (2009) · BMC Pediatrics · doi:10.1186/1471-2431-9-18 · Cited by 118 · see citing works
Improving Childhood Vaccination Rates
Diekema, D. S. (2012) · New England Journal of Medicine · doi:10.1056/nejmp1113008 · Cited by 114 · see citing works
Physician Response to Parental Requests to Spread Out the Recommended Vaccine Schedule
Kempe, A., O’Leary, S. T., Kennedy, A., Crane, L. A., Allison, M. A., Beaty, B. L., Hurley, L. P., Brtnikova, M., Jimenez-Zambrano, A. M., & Stokley, S. K. (2015) · PEDIATRICS · doi:10.1542/peds.2014-3474 · Cited by 113 · see citing works
Vaccination Coverage Among Children in Kindergarten — United States, 2014–15 School Year
Seither, R., Calhoun, K., Knighton, C. L., Mellerson, J. L., Meador, S. A., Tippins, A., Greby, S. M., & DIETZ, V. J. (2015) · MMWR Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm6433a2 · Cited by 104 · see citing works
Effective Pain Reduction for Multiple Immunization Injections in Young Infants
Reis, E. C., Roth, E. K., Syphan, J. L., et al. (2003) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpedi.157.11.1115 · Cited by 100 · see citing works
Parent and provider perspectives on immunization: Are providers overestimating parental concerns?
Healy, C. M., Montesinos, D. P., & Middleman, A. B. (2013) · Vaccine · doi:10.1016/j.vaccine.2013.11.076 · Cited by 99 · see citing works
Vannice, K., Salmon, D. A., Shui, I. M., et al. (2011) · PEDIATRICS · doi:10.1542/peds.2010-1722r · Cited by 99 · see citing works
Frequency of Alternative Immunization Schedule Use in a Metropolitan Area
Robison, S. G., Groom, H. C., & Young, C. M. (2012) · PEDIATRICS · doi:10.1542/peds.2011-3154 · Cited by 98 · see citing works
The Problem With Dr Bob's Alternative Vaccine Schedule
Offit, P. A., & Moser, C. A. (2008) · PEDIATRICS · doi:10.1542/peds.2008-2189 · Cited by 94 · see citing works
McCauley, M. M., Kennedy, A., Basket, M. M., & Sheedy, K. (2012) · Academic Pediatrics · doi:10.1016/j.acap.2012.06.007 · Cited by 93 · see citing works
The Role of the Vaccine Adverse Event Reporting System (VAERS) in Monitoring Vaccine Safety
Iskander, J. K., Miller, E. R., & Chen, R. T. (2004) · Pediatric Annals · doi:10.3928/0090-4481-20040901-11 · Cited by 77 · see citing works
Law, Ethics, and Public Health in the Vaccination Debates
Gostin, L. O. (2015) · JAMA · doi:10.1001/jama.2015.1518 · Cited by 73 · see citing works
Vaccination coverage among children in kindergarten - United States, 2013-14 school year.
Seither, R., Masalovich, S. E., Knighton, C. L., et al. (2014) · PubMed · Cited by 63 · see citing works
Underimmunization in Ohio's Amish: Parental Fears Are a Greater Obstacle Than Access to Care
Wenger, O. K., McManus, M. D., Bower, J. R., & Langkamp, D. L. (2011) · PEDIATRICS · doi:10.1542/peds.2009-2599 · Cited by 58 · see citing works
Legislative Prescriptions for Controlling Nonmedical Vaccine Exemptions
Yang, Y. T., & Silverman, R. D. (2015) · JAMA · doi:10.1001/jama.2014.16286 · Cited by 50 · see citing works
Post-licensure rapid immunization safety monitoring program (PRISM) data characterization
Baker, M. A., Nguyen, M., Cole, D. V., Lee, G. M., & Lieu, T. A. (2013) · Vaccine · doi:10.1016/j.vaccine.2013.04.088 · Cited by 50 · see citing works
Personal Belief Exemptions to Vaccination in California: A Spatial Analysis
Carrel, M., & Bitterman, P. (2015) · PEDIATRICS · doi:10.1542/peds.2015-0831 · Cited by 44 · see citing works
Physician Dismissal of Families Who Refuse Vaccination: An Ethical Assessment
Diekema, D. S. (2015) · The Journal of Law Medicine & Ethics · doi:10.1111/jlme.12307 · Cited by 41 · see citing works
Cohen, G. J. (2009) · PEDIATRICS · doi:10.1542/peds.2009-1785 · Cited by 38 · see citing works
Williams, S. E., Klein, N. P., Halsey, N. A., Dekker, C. L., Baxter, R. P., Marchant, C. D., LaRussa, P. S., Sparks, R. C., Tokars, J. I., Pahud, B. A., et al. (2011) · Vaccine · doi:10.1016/j.vaccine.2011.07.044 · Cited by 37 · see citing works
Self-citationWashington State Pediatricians' Attitudes Toward Alternative Childhood Immunization Schedules
Wightman, A. G., Opel, D. J., Marcuse, E. K., & Taylor, J. A. (2011) · PEDIATRICS · doi:10.1542/peds.2011-0666 · Cited by 36 · see citing works
Professional Responsibility and Early Childhood Vaccination
Chervenak, F. A., McCullough, L. B., & Brent, R. L. (2015) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2015.10.076 · Cited by 33 · see citing works
Reaffirmation: Responding to Parents Who Refuse Immunization for Their Children
(2013) · PEDIATRICS · doi:10.1542/peds.2013-0430 · Cited by 33 · see citing works
Halperin, B. A., Melnychuk, R., Downie, J., et al. (2007) · Paediatrics & Child Health · doi:10.1093/pch/12.10.843 · Cited by 30 · see citing works
Provider dismissal of vaccine-hesitant families: Misguided policy that fails to benefit children
Diekema, D. S. (2013) · Human Vaccines & Immunotherapeutics · doi:10.4161/hv.26284 · Cited by 27 · see citing works
Williams, S. E., & Swan, R. R. (2014) · Vaccine · doi:10.1016/j.vaccine.2014.04.001 · Cited by 27 · see citing works
Vaccine Policy and Arkansas Childhood Immunization Exemptions
Safi, H., Wheeler, J. G., Reeve, G. R., et al. (2012) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2012.02.022 · Cited by 27 · see citing works
Are Recent Medical Graduates More Skeptical of Vaccines?
Hughes, M. M., Omer, S. B., Pan, W., et al. (2013) · Vaccines · doi:10.3390/vaccines1020154 · Cited by 23 · see citing works
The Pediatrician's Dilemma: Refusing the Refusers of Infant Vaccines
Block, S. L. (2015) · The Journal of Law Medicine & Ethics · doi:10.1111/jlme.12306 · Cited by 22 · see citing works
Medicolegal Issues in Pediatrics
AAP Committee on Medical Liability and Risk Management (2011) · American Academy of Pediatrics eBooks · doi:10.1542/9781581107012 · Cited by 18 · see citing works
Vaccines: Can Transparency Increase Confidence and Reduce Hesitancy?
Byington, C. L. (2014) · PEDIATRICS · doi:10.1542/peds.2014-1494 · Cited by 17 · see citing works
Self-citationFine, P., & Mulholland, K. (2013) · Elsevier eBooks · doi:10.1016/b978-1-4557-0090-5.00071-9 · Cited by 16 · see citing works
Wolf, E. R., Rowhani‐Rahbar, A., & Opel, D. J. (2015) · Expert Review of Vaccines · doi:10.1586/14760584.2015.1037289 · Cited by 8 · see citing works
Patient dismissal: the right way to do it.
Lippman, H., & Davenport, J. (2011) · PubMed · Cited by 7 · see citing works
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Cooper, D. M., Afghani, B., Byington, C. L., Cunningham, C. K., Golub, S., Lu, K. D., Radom-Aizik, S., Ross, L. F., Singh, J., Smoyer, W. E., et al. (2021) · Pediatric Research · doi:10.1038/s41390-021-01402-z · Cited by 55 · see citing works
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Shah, M. D., Szilagyi, P. G., Shetgiri, R., Delgado, J. R., Vangala, S., Thomas, K., Dudovitz, R. N., Vizueta, N., Darling, J., & Kapteyn, A. (2022) · Pediatrics · doi:10.1542/peds.2022-057855 · Cited by 25 · see citing works
- Authors
- Edwards, K. M., Hackell, J. M., THE COMMITTEE ON INFECTIOUS DISEASES, T. C. O. P. A. A. M., Byington, C. L., Maldonado, Y. A., Barnett, E. D., Davies, H. D., Edwards, K. M., Lynfield, R., Munoz, F. M., Nolt, D., Nyquist, A.-C., Rathore, M. H., Sawyer, M. H., Steinbach, W. J., Tan, T. Q., Zaoutis, T. E., Simon, G. R., Baker, C. N., Barden, G. A., Brown, O. “. W., Hackell, J. M., Hardin, A. P., Meade, K. E., Moore, S. B., & Richerson, J. E.
- ORCID
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2016-09-01
- Volume
- 138
- Issue
- 3
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W2511594916
- Cited by
- 302
- References
- 77
- Citations by year
- 2026: 5 · 2025: 13 · 2024: 25 · 2023: 30 · 2022: 47 · 2021: 58 · 2020: 46 · 2019: 29 · 2018: 27 · 2017: 19 · 2016: 2
- FWCI
- 33.87
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by
- Locations
- PEDIATRICS (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Health › Vaccine Coverage and Hesitancy
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Ethics and Legal Issues in Pediatric Healthcare
- Health Sciences › Medicine › Emergency Medicine › Intramuscular injections and effects
- Keywords
- vaccine hesitancy, vaccine refusal, parental concerns, vaccine safety, immunization, vaccine-preventable diseases, childhood immunization
- MeSH terms
- Pediatricians, Vaccination Refusal, Child, Clinical Trials as Topic, Communication, Health Education, Humans, Health Knowledge, Attitudes, Practice, Parents, Patient Acceptance of Health Care, Safety, Vaccination, Refusal to Treat, Adverse Drug Reaction Reporting Systems, Immunity, Herd
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