Vaccine confidence and hesitancy in Brazil.

Amy Louise Brown,Rodrigo M A Leite,Heidi Larson,Regina M Succi,Marcelo Henrique Napimoga,Cecília P Turssi,Marcelo Sperandio,Victor Ferro Berton

doi:10.1590/0102-311x00011618

Amy Louise Brown, Rodrigo M A Leite + Show 6 more

Open Access

https://doi.org/10.1590/0102-311x00011618

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Abstract

Despite the overall benefits of immunization, vaccine hesitancy has been a growing trend and has been associated with the resurgence of vaccine-preventable diseases. The aim of this study was to assess vaccine confidence and hesitancy in Brazil, as part of a wider project to map vaccine confidence globally. One thousand subjects were interviewed, either online or face-to-face, based on a general questionnaire regarding perceptions on vaccines and vaccination. Further exploratory questions were used with the subset of respondents who were parents of children aged under 5. Such questions extracted information regarding vaccination behavior, opinions on vaccination and government health services, and vaccine hesitancy. Reasons for hesitancy were classified as relating to confidence, convenience and/or complacency, and the population was also analyzed socio-demographically. The results showed that overall confidence in immunization was higher than confidence in family planning services, community health workers and emergency services. Seventy-six people reported hesitancy to vaccinate. The commonest reasons for hesitancy were issues with confidence (41.4%), efficacy/safety of the vaccine (25.5%) and concerns about adverse events (23.6%). The sociodemographic analysis revealed that vaccine hesitancy was associated with marital status, level of education and income. Despite overall vaccine confidence being high, a clear trend toward lower levels of confidence was associated with higher levels of hesitancy, which warrants on-going monitoring, due to the dynamic and changing nature of vaccine hesitancy.

Highlights

Despite the overwhelming evidence on the overall benefits of immunization, vaccine hesitancy has been gaining considerable ground 1,2,3
In order to ascertain the inclusion of participants from different socioeconomic and educational backgrounds, reducing the risk of sampling bias derived from web-based interviews only, face-to-face interviews were carried out on a convenience sample comprised of graduate dental surgeons as well as patients and/or accompanying parents of children who were attending oral health check/treatment clinics in Campinas, São Paulo State, Brazil
Confidence in immunization was higher than confidence in family planning services, community health workers and Brazilian Unified National Health System (SUS) emergency services (Table 1)

Summary

Introduction

Despite the overwhelming evidence on the overall benefits of immunization, vaccine hesitancy has been gaining considerable ground 1,2,3 This is a serious cause for concern as it has been associated with the resurgence of vaccine-preventable diseases such as measles in the United States 4 and Europe 5. In Brazil, measles-mumps-rubella vaccine coverage has been dropping steadily since 2013, causing concerns that pockets of unimmunized people may be growing nationwide, bringing the risk of new outbreaks of vaccine-preventable diseases 6. In this context, it is more important than ever to better understand the dynamics of vaccine confidence in Brazil. Caring parents and/or guardians do not refuse vaccines to intentionally compromise their children’s health; they do so instead because they genuinely believe they are making the best choice for their child 7

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