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Vaccines
Special Issues
Strategies to Address Falling Vaccine Coverage and Vaccine Hesitancy
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Strategies to Address Falling Vaccine Coverage and Vaccine Hesitancy

A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "Human Vaccines and Public Health".

Deadline for manuscript submissions: closed (31 March 2025) | Viewed by 6172

Special Issue Editor

Dr. Georgios Marinos

E-Mail Website
Guest Editor
Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
Interests: COVID-19; vaccination coverage; vaccines hesitancy; health professionals
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Vaccination is an important and effective public health intervention; however, vaccine coverage has been declining in many regions worldwide, increasing the risk of vaccine-preventable diseases. Vaccine hesitancy, which refers to the delay in accepting or refusing vaccines despite their availability, is influenced by numerous factors, including complacency, convenience, and confidence. Understanding and addressing these factors is crucial to reversing the falling vaccine coverage trend.

This Special Issue explores strategies and interventions to counteract falling vaccine coverage and vaccine hesitancy. It seeks to better understand the underlying causes of vaccine hesitancy, evaluate the effectiveness of different intervention strategies, and provide practical recommendations. In this Special Issue, we welcome original research articles and reviews that cover various aspects of vaccine coverage and hesitancy, including but not limited to the following:

  • Determinants of vaccine hesitancy;
  • Misinformation/inadequate communication;
  • Promoting vaccine acceptance and intervention effectiveness;
  • Community approaches to increasing vaccine uptake;
  • Innovations that support vaccination campaigns;

I look forward to receiving your contributions.

Dr. Georgios Marinos
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Vaccines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • vaccine hesitancy
  • vaccine coverage
  • public health
  • immunization
  • vaccination campaigns
  • misinformation
  • healthcare communication
  • policy interventions
  • community health
  • ethical considerations

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Published Papers (5 papers)

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Research

Jump to: Review

14 pages, 230 KiB  
Article
Factors Explaining Responses to Influenza and COVID-19 Vaccination Among Nurses in Israel
by Ola Ali-Saleh
Vaccines 2025, 13(5), 454; https://doi.org/10.3390/vaccines13050454 - 24 Apr 2025
Viewed by 197
Abstract
Background/Objectives: During the COVID-19 pandemic, influenza vaccination compliance among nurses in Israel was significantly lower than in previous years. This study sought to evaluate factors associated with vaccination compliance. Methods: An online cross-sectional survey conducted in March-April 2022 among 386 Israeli [...] Read more.
Background/Objectives: During the COVID-19 pandemic, influenza vaccination compliance among nurses in Israel was significantly lower than in previous years. This study sought to evaluate factors associated with vaccination compliance. Methods: An online cross-sectional survey conducted in March-April 2022 among 386 Israeli nurses examined perceived disease threat, vaccination barriers, perceived vaccine benefits, attitudes, and subjective norms/social influences. Results: During the 2021/2022 winter season, the vaccination rate for COVID-19 was higher than for influenza (68.4% vs. 61.9%). For both, vaccination compliance was positively associated with perceived susceptibility and severity, perceived benefits, and supporting attitude and negatively associated with barriers. The odds for COVID-19 vaccination were higher among older (OR = 1.04, 95% CI = 1.02, 1.07, p < 0.001) and more experienced nurses (age and years of experience, r = 0.89, p < 0.001). For both, perceived susceptibility and severity were higher among female nurses (influenza M = 3.29 SD = 0.88; COVID-19 M = 3.65 SD = 0.83) than male nurses (influenza M = 3.03 SD = 0.90; COVID-19 M = 3.32 SD = 0.83). A model assessing the associations between COVID-19-related variables and influenza vaccination compliance found that higher perceived susceptibility and severity regarding COVID-19, lower perceived barriers to COVID-19 vaccination, and more supportive attitudes toward COVID-19 vaccination were related to a greater likelihood of influenza vaccination compliance. Conclusions: Perceived susceptibility, perceived severity, and attitudes made a significantly greater contribution to influenza vaccination than to COVID-19 vaccination, whereas perceived benefits made a significantly greater contribution to COVID-19 vaccination than to influenza vaccination. Full article
(This article belongs to the Special Issue Strategies to Address Falling Vaccine Coverage and Vaccine Hesitancy)
14 pages, 674 KiB  
Article
Vaccination Education Deficits and Vaccine Hesitancy Among Healthcare Students in Japan: A Cross-Sectional Study
by Aya Saitoh, Hiromi Oku, Tomohiro Katsuta, Hajime Kamiya, Yoichi Ishikawa, Mayumi Takaku and Akihiko Saitoh
Vaccines 2024, 12(12), 1310; https://doi.org/10.3390/vaccines12121310 - 22 Nov 2024
Viewed by 1089
Abstract
Background/Objectives: Healthcare professionals’ (HCPs’) accurate knowledge of and positive attitudes toward immunization greatly influence society’s acceptance of it. Early and appropriate immunization education for HCP students is vital. This study aimed to understand current immunization education and vaccine hesitancy among medical, nursing, and [...] Read more.
Background/Objectives: Healthcare professionals’ (HCPs’) accurate knowledge of and positive attitudes toward immunization greatly influence society’s acceptance of it. Early and appropriate immunization education for HCP students is vital. This study aimed to understand current immunization education and vaccine hesitancy among medical, nursing, and pharmacy students in Japan. Methods: An anonymous self-administered online questionnaire was administered to final-year medical, nursing, and pharmacy students in Japan between 6 and 31 March 2023. Survey items assessed current immunization education, preparedness for clinical practice, immunization knowledge, and the degree of vaccine hesitancy. Results: Overall, 525 students (127 (24.2%) medical, 252 (48.0%) nursing, and 146 (27.8%) pharmacy) responded, of whom 39.8% raised concerns regarding new vaccine risks (24.4%,15.9%, and 23.3%, respectively; p = 0.22) and adverse effects (14.2%, 12.7%, and 17.1%, respectively; p = 0.57), including trust in government information (61.4%, 50/4%, and 56.8%, respectively; p = 0.337) or recommended vaccines (57.5%, 4.7%, and 43.8%, respectively; p = 0.113). Preparedness for future clinical practice varied significantly among schools, with medical students (54%) feeling more prepared compared to nursing (34.3%) and pharmacy students (39.1%) (p < 0.001). The average correct immunization knowledge rate was 59.9%, with significant differences between schools (medical 62.7%, nursing 57.6%, and pharmacy 59.6%; p < 0.001). There was no significant correlation between knowledge level and self-assessed preparedness (r = 0.066, p = 0.132). The HCP students wished to receive more immunization education and sought improvements in comprehensive knowledge, communication skills, and practice-based content. Conclusions: For Japan’s HCP students, the enhancement of immunization education focusing on hesitancy and risk–benefit communication is necessary. Full article
(This article belongs to the Special Issue Strategies to Address Falling Vaccine Coverage and Vaccine Hesitancy)
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19 pages, 611 KiB  
Article
Analyzing Changes in Attitudes and Behaviors towards Seasonal Influenza Vaccination in Spain’s Adult Population over Three Seasons
by Camino Prada-García, Marina Toquero-Asensio, Virginia Fernández-Espinilla, Cristina Hernán-García, Iván Sanz-Muñoz, Jose M. Eiros and Javier Castrodeza-Sanz
Vaccines 2024, 12(10), 1162; https://doi.org/10.3390/vaccines12101162 - 12 Oct 2024
Viewed by 1383
Abstract
Background/Objectives: The experience of the COVID-19 pandemic has turned the spotlight on the importance of public health measures and disease prevention. Despite this, the acceptance of influenza vaccination has remained low in most countries (and far from the 75% target set by [...] Read more.
Background/Objectives: The experience of the COVID-19 pandemic has turned the spotlight on the importance of public health measures and disease prevention. Despite this, the acceptance of influenza vaccination has remained low in most countries (and far from the 75% target set by the World Health Organization). The objective of this study has been to investigate how attitudes and behaviors regarding influenza vaccination in the Spanish adult population have changed over the last three years (from 2021 to 2024) in order to analyze trends in influenza vaccination. Methods: To this end, a cross-sectional study was conducted through 2206 telephone interviews, and the results were compared with those obtained in previous campaigns. Results: The findings indicate a significant decline in overall vaccination intent. Healthcare professionals remain the most influential factor in encouraging vaccination, yet there is a notable increase in the lack of vaccine recommendations, contributing to the decision not to vaccinate. This study also reveals low awareness of the influenza vaccine campaign, emphasizing the need for improved public health communication. Conclusions: To counteract these trends, this study recommends intensifying awareness campaigns, strengthening the role of healthcare providers in vaccine advocacy, and tailoring communication strategies. These efforts are crucial to enhancing vaccination coverage and protecting vulnerable populations against influenza. Full article
(This article belongs to the Special Issue Strategies to Address Falling Vaccine Coverage and Vaccine Hesitancy)
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12 pages, 458 KiB  
Article
Hesitancy toward Childhood and Influenza Vaccines: Experiences from Highly Educated Jordanian Parents
by Montaha Al-Iede, Mohammad Aljahalin, Eva Fashho, Sami Sweis, Rahaf Mesmeh, Loai Bani Hamad, Leen Abuzaid, Jana Al Sa’ed, Yasmeen Elbetar, Aya Yaseen Mahmood Alabdali, Shahed Al-Nawaiseh and Abdallah Al-Ani
Vaccines 2024, 12(8), 945; https://doi.org/10.3390/vaccines12080945 - 22 Aug 2024
Cited by 1 | Viewed by 1854
Abstract
We aimed to examine vaccine hesitancy and knowledge towards influenza vaccines among Jordanian parents. Data were collected via an online questionnaire distributed between October 2023 and March 2024. They included sections on demographics, parental attitudes towards childhood vaccines (PACVs), and knowledge and practices [...] Read more.
We aimed to examine vaccine hesitancy and knowledge towards influenza vaccines among Jordanian parents. Data were collected via an online questionnaire distributed between October 2023 and March 2024. They included sections on demographics, parental attitudes towards childhood vaccines (PACVs), and knowledge and practices towards influenza vaccines. Associations were examined using the chi-squared test. A binary logistic regression model was utilized to determine predictors of vaccine usage. A total of 3208 participants were included, of which 9.3% were vaccine hesitant per the PACV categorization. Fathers were more likely to be vaccine hesitant (OR: 1.40; 95CI: 1.07–1.85). Similarly, divorced parents (OR: 1.80; 95CI: 1.05–3.12) were significantly more vaccine hesitant compared to their married counterparts. Conversely, higher monthly income (OR: 0.66; 95CI: 0.48–0.92), working in healthcare settings (OR: 0.71; 95CI: 0.51–0.98), and adherence to national vaccination policies (OR: 0.07; 95CI: 0.04–0.13) were significantly associated with a lower likelihood of vaccine hesitancy. Multivariate analysis shows that a healthcare-related occupation (OR: 0.62; 95CI: 0.44–0.87), semi-compliance (OR: 0.37; 95CI: 0.22–0.64), full compliance (OR: 0.08; 95CI: 0.05–0.13) with national vaccine guidelines, and knowledge scores of influenza and vaccines (OR: 0.79; 95CI: 0.75–0.84) were the only independent factors influencing vaccine hesitancy. Finally, non-hesitant participants were significantly more likely to give the influenza vaccine to their children at the present or future time (OR: 2.07; 95CI: 1.53–2.80). Our findings highlight the complexity of vaccine hesitancy and underscore the importance of tailored interventions. Cultural, socioeconomic, and individual factors play significant roles in shaping attitudes toward vaccination. An understanding of the aforementioned among Jordanian parents provides insights for public health initiatives. Compliance with national vaccination guidelines and addressing concerns about vaccine safety are essential for improving childhood vaccination rates in Jordan. Full article
(This article belongs to the Special Issue Strategies to Address Falling Vaccine Coverage and Vaccine Hesitancy)
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Review

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20 pages, 325 KiB  
Review
The Influence of Financial Incentives on Vaccination Hesitancy: A Narrative Review of Recent Research
by Jason Wong, Camrin Gill, Amir Abdo and Ava Eisa
Vaccines 2025, 13(3), 256; https://doi.org/10.3390/vaccines13030256 - 28 Feb 2025
Viewed by 938
Abstract
Background: Vaccine hesitancy represents a significant global health challenge that greatly hinders public health efforts focused on managing the transmission of infectious diseases. A wealth of original research conducted worldwide has examined various incentives that could help alleviate vaccine hesitancy and increase vaccination [...] Read more.
Background: Vaccine hesitancy represents a significant global health challenge that greatly hinders public health efforts focused on managing the transmission of infectious diseases. A wealth of original research conducted worldwide has examined various incentives that could help alleviate vaccine hesitancy and increase vaccination rates. Although some findings are conflicting, no comprehensive review has yet assessed the overall effectiveness of these strategies. This study aims to bridge this knowledge gap by examining how financial incentives influence people’s willingness to undergo vaccination. Methods: In August 2024, we extensively searched four databases for studies focusing on financial incentives and vaccination rates. Examples of financial incentives included lottery tickets and hypothetical or physical monetary rewards ranging in various amounts depending on the study. We selected nineteen relevant articles from a larger pool and evaluated them for validity and bias. Results: Around eighty percent of the research focused on COVID-19 vaccines, driven by the ongoing pandemic and the debates surrounding their use. Most of the studies indicated a positive influence of financial incentives on vaccination rates, although they often came with a higher risk of bias. Conversely, several studies suggest that financial incentives do not result in benefits. Instead, they highlight other factors that have a more profound effect on influencing people to undergo vaccination. The remaining studies are inconclusive regarding the effectiveness of financial incentives, concluding the need for further research. The strategies to mitigate these concerns included a combination of legal and monetary incentives. Summary: The effectiveness of financial incentives in boosting vaccination rates seems to differ significantly based on the region and context. They tend to be more effective in economically disadvantaged developing countries. In contrast, in developed nations, they may be ineffective or counterproductive due to various confounding factors such as financial background, lack of trust in the healthcare system, and/or lack of patient education. In resource-rich areas, educational programs often yield better results, and addressing widespread mistrust in healthcare systems and governmental policies through transparency is essential. Ultimately, employing tailored incentives alongside public education could enhance vaccination acceptance, particularly in culturally diverse countries like the United States, where understanding community preferences is crucial. Full article
(This article belongs to the Special Issue Strategies to Address Falling Vaccine Coverage and Vaccine Hesitancy)
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