Abstract

Vaccination is among the most cost-effective interventions for protecting populations against infectious diseases. Individuals exhibiting vaccine hesitancy may eventually accept some or all vaccines, may delay them, or may reject specific ones. In contrast, vaccine refusal denotes the complete voluntary rejection of all vaccines in the current immunization program. Vaccine refusal represents a significant public health concern, threatening both individual and community health. Opposition to vaccines has existed since their inception and continues to grow, particularly with the influence of the internet and social media. Some of the reasons for vaccine refusal include concerns about the vaccine components, distrust in vaccines, religious beliefs, reservations about the pharmaceutical industry, and fear of adverse effects. This review aims to explore the etiology of vaccine refusal based on current literature.

Keywords: Child, etiology, vaccine hesitancy, vaccine refusal

References

  1. World Health Organization (WHO). How do vaccines work? [Internet]. [cited 2023 Jul 12]. Available from: https://www.who.int/news-room/feature-stories/detail/how-do-vaccines-work
  2. Bekis Bozkurt H. An overview of vaccine rejection and review of literature. Kafkas J Med Sci. 2018;8(1):71-6. https://doi.org/10.5505/kjms.2018.12754
  3. Report of the SAGE Working Group on Vaccine Hesitancy [Internet]. 2014 Nov 12. [cited 2023 Jul 12].
  4. Nelson MC, Rogers J. The right to die? Anti-vaccination activity and the 1874 smallpox epidemic in Stockholm. Soc Hist Med. 1992;5(3):369-88. https://doi.org/10.1093/shm/5.3.369
  5. Durbach N. Bodily matters: The anti-vaccination movement in England, 1853-1907. Durham, NC: Duke University Press; 2005. https://doi.org/10.1215/9780822386506
  6. Prabhu M. Ye olde anti-vaxxers. Gavi, the Vaccine Alliance [Internet]. [cited 2023 Jul 19]. Available from:
  7. Swales JD. The Leicester anti-vaccination movement. Lancet. 1992;340(8826):1019-21. https://doi.org/10.1016/0140-6736(92)93021-E
  8. Wolfe RM, Sharp LK. Anti-vaccinationists past and present. BMJ. 2002;325(7361):430-2. https://doi.org/10.1136/bmj.325.7361.430
  9. Ołpiński M. Anti-vaccination movement and parental refusals of immunization of children in USA. Pediatr Pol. 2012;87(4):381-5. https://doi.org/10.1016/j.pepo.2012.05.003
  10. Nuwarda RF, Ramzan I, Weekes L, Kayser V. Vaccine hesitancy: Contemporary issues and historical background. Vaccines (Basel). 2022;10(2):247. https://doi.org/10.3390/vaccines10101595
  11. Kulenkampff M, Schwartzman JS, Wilson J. Neurological complications of pertussis inoculation. Arch Dis Child. 1974;49(2):46-9. https://doi.org/10.1136/adc.49.1.46
  12. Badur S. Anti-vaccination: vaccine hesitancy and refusal. Ankem Derg. 2011;25(2):82-6.
  13. Centers for Disease Control and Prevention (CDC). Guillain-Barré Syndrome and vaccines [Internet]. [cited 2023 Jul 19]. Available from: https://www.cdc.gov/vaccinesafety/concerns/guillain-barre-syndrome.html
  14. Confavreux C, Suissa S, Saddier P, Bourdes V, Vukusic S. Vaccinations and the risk of relapse in multiple sclerosis. N Engl J Med. 2001;344(5):319-26. https://doi.org/10.1056/NEJM200102013440501
  15. Wakefield AJ, Murch SH, Anthony A, Linnell J, Casson DM, Malik M, et al. Retracted: Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet. 1998;351(9103):637-41. https://doi.org/10.1016/S0140-6736(97)11096-0
  16. Jegede AS. What led to the Nigerian boycott of the polio vaccination campaign? PLoS Med. 2007;4(3):e73. https://doi.org/10.1371/journal.pmed.0040073
  17. Smith TC. Vaccine rejection and hesitancy: A review and call to action. Open Forum Infect Dis. 2017;4(3):ofx146. https://doi.org/10.1093/ofid/ofx146
  18. Kara A, Çiftçi E, Tezer H, Somer A, editors. Aşı ve Bağışıklama. Aşılar ve Civa İddiaları. 1st ed. Ankara: Selen Medya Yayıncılık. 2021; 877-878.
  19. Kara A, Çiftçi E, Tezer H, Somer A, editors. Aşı ve Bağışıklama. Aşılar ve Otizm İddiaları. 1st ed. Ankara: Selen Medya Yayıncılık; 2021:897-904.
  20. Taylor LE, Swerdfeger AL, Eslick GD. Vaccines are not associated with autism: An evidence-based meta-analysis of case-control and cohort studies. Vaccine. 2014 ;32(29):3623-9. https://doi.org/10.1016/j.vaccine.2014.04.085
  21. T.C. Sağlık Bakanlığı. Aşılar ile otizm arasında ilişki var mıdır? [Internet]. [cited 2023 Jul 25]. Available from: https://asi.saglik.gov.tr
  22. Bults M, Beaujean DJMA, Richardus JH, van Steenbergen JE, Voeten HACM. Pandemic influenza A (H1N1) vaccination in The Netherlands: Parental reasoning underlying child vaccination choices. Vaccine. 2011;29(37):6226-35. https://doi.org/10.1016/j.vaccine.2011.06.075
  23. Yağcı-Küpeli B, Kiper N. Interactions between physicians and drugindustry. Cukurova Med J. 2016;41:777-81. https://doi.org/10.17826/cutf.254526
  24. Ağalar C, Ağalar F, Sayek İ. The interactions between doctorsand pharmaceutical companies. Çocuk Sağlığı ve Hastalıkları Dergisi. 2005;48:273-83.
  25. Taşçı Ö, Gökler ME. Aşı karşıtlarının sosyal medya paylaşımlarının incelenmesi: Instagram örneği. Med Res Rep. 2021;4(2):23-30.
  26. Etesaminia S, Bağcı Derinpınar K. The role of social media in vaccıne hesitation. Usaysad Derg. 2021;7(2):377-90.
  27. Türkiye İstatistik Kurumu (TÜİK). Hanehalkı Bilişim Teknolojileri Kullanım Araştırması 2022 [Internet]. [cited 2023 Jul 27]. Available from: https://data.tuik.gov.tr
  28. T.C. Sağlık Bakanlığı. Aşı içerikleri [Internet]. [cited 2023 Jul 13]. Available from: https://covid19asi.saglik.gov.tr
  29. Büyükkalay BN. Vaccine Rejection and Motivation Sources of Vaccine Rejected People. Int Soc Mentality Res Thinkers J. 2022;8(65):2116-26. https://doi.org/10.29228/smryj.65987
  30. Fourn L, Haddad S, Fournier P, Gansey R. Determinants of parents’ reticence toward vaccination in urban areas in Benin (West Africa). BMC Int Health Hum Rights. 2009;9(Suppl 1):S1-5. https://doi.org/10.1186/1472-698X-9-S1-S14
  31. The Liberty Beacon. The vaccine illusion: How vaccination compromises our natural immunity and what we can do to regain our health [Internet]. [cited 2023 Aug 10]. Available from: https://www.thelibertybeacon.com
  32. McKee CP, Bohannon KB. Exploring the reasons behind parental refusal of vaccines. J Pediatr Pharmacol Ther. 2016;21(2):104-9. https://doi.org/10.5863/1551-6776-21.2.104
  33. Dirlik R. Aşıyı ve tapınak tıbbını savunan katil. [Internet]. [cited 2023 Aug 10]. Available from: https://ruhadirlik.blogspot.com/2016/01/asiyi-ve-tapinak-tibbini-savunan.html
  34. Immunization Action Coalition. Vaccine work [Internet]. Available from: https://www.immunize.org/catg.d/p4037.pdf
  35. Hızel Bülbül S, Turgut M, Köylüoğlu S. Çocuklarda tıp dışı alternatif uygulamalar konusunda ailelerin görüşleri. Çocuk Sağlığı ve Hastalıkları Dergisi. 2009;52:195-202.
  36. Çıtak G, Aksoy Duran Ö. An Important Obstacle in Vaccination: Vaccination Rejection. Erciyes Univ Health Sci Fac J. 2020;7(2):15-20.
  37. Cobos Muñoz D, Monzón Llamas L, Bosch-Capblanch X. Exposing concerns about vaccination in low- and middle-income countries: A systematic review. Int J Public Health. 2015;60(7):767-80. https://doi.org/10.1007/s00038-015-0715-6
  38. Khowaja AR, Khan SA, Nizam N, Bin Omer S, Zaidi A. Parental perceptions surrounding polio and self-reported non-participation in polio supplementary immunization activities in Karachi, Pakistan: A mixed methods study. Bull World Health Organ. 2012;90:822-30. https://doi.org/10.2471/BLT.12.106260
  39. Cumhuriyet. Yargıtay’dan aşı kararına ikinci ret [Internet]. [cited 2023 Jul 19]. Available from: https://www.cumhuriyet.com.tr/haber/yargitaydan-asi-kararina-ikinci-ret-531726
  40. Gür E. Vaccine hesitancy - vaccine refusal. Turk Pediatri Ars. 2019;54(1):1-2. https://doi.org/ 10.14744/TurkPediatriArs.2019.79990
  41. Betsch C, Böhm R, Chapma GB. Using behavioral insights to increase vaccination policy effectiveness. Policy Insights from the Behavioral and Brain Sciences, 2018;5(1):61-9. https://doi.org/10.1177/2372732217752066
  42. Larson HJ, Gakidou E, Murray CJL. The vaccine-hesitant moment. New England Journal of Medicine, 202;387(1):58-65. https://doi.org/10.1056/NEJMra2106441
  43. World Health Organization. Behavioural and social drivers of vaccination: Tools and practical guidance for achieving high uptake. 2023
  44. Kempe A, Saville AW, Albertin C, Zimet G, Breck A, Helmkamp L, Dickinson LM. Parental hesitancy about routine childhood and influenza vaccinations: A national survey. Pediatrics 2020;146(1):e20193852. https://doi.org/10.1542/peds.2019-3852

Copyright and license

How to cite

1.
Altınışık İ, Özaydın E, Kara Uzun A. An overview of the etiology of vaccine hesitancy and refusal. Turk J Pediatr Dis [Internet]. 2025 May 14 [cited 2025 May 24];19(3):143-7. Available from: https://turkjpediatrdis.org/article/view/1092