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Vaccines
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Acceptance and Hesitancy in Vaccine Uptake: 2nd Edition
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Acceptance and Hesitancy in Vaccine Uptake: 2nd Edition

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

Deadline for manuscript submissions: 31 October 2025 | Viewed by 5687

Special Issue Editor

Dr. Sherri Sheinfeld Gorin

E-Mail Website
Guest Editor
Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA
Interests: cancer prevention interventions; human papillomavirus vaccine
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

I am pleased to announce the second edition of the Special Issue "Acceptance and Hesitancy in Vaccine Uptake”. This Special Issue will build on the research published in the first edition by identifying intervention strategies to overcome barriers to vaccination, reduce hesitancy, and increase uptake among diverse populations worldwide. We encourage submissions that share findings based on the application of innovative research methods to increase vaccine uptake. Research exploring human papillomavirus (HPV) vaccines is welcomed. For this Special Issue, we invite the submission of all types of papers, including original research articles, reviews, and short communications, with no restrictions on the type of submission. We look forward to receiving your contributions.

Dr. Sherri Sheinfeld Gorin
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 acceptance
  • vaccine hesitancy
  • vaccine uptake
  • vaccination

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Related Special Issue

Published Papers (6 papers)

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13 pages, 2893 KiB  
Article
Vaccine Attitudes, Knowledge, and Confidence Among Nursing, Pediatric Nursing, and Midwifery Undergraduate Students in Italy
by Ersilia Buonomo, Daniele Di Giovanni, Gaia Piunno, Stefania Moramarco, Giuliana D’Elpidio, Ercole Vellone, Enkeleda Gjini, Mariachiara Carestia, Cristiana Ferrari and Luca Coppeta
Vaccines 2025, 13(8), 813; https://doi.org/10.3390/vaccines13080813 - 30 Jul 2025
Viewed by 350
Abstract
Background: Vaccine hesitancy (VH) represents a growing concern among healthcare professionals and students, potentially undermining public health efforts. Nursing, pediatric nursing, and midwifery students are future vaccinators and educators, making it essential to understand their attitudes, knowledge, and confidence toward vaccination. This study [...] Read more.
Background: Vaccine hesitancy (VH) represents a growing concern among healthcare professionals and students, potentially undermining public health efforts. Nursing, pediatric nursing, and midwifery students are future vaccinators and educators, making it essential to understand their attitudes, knowledge, and confidence toward vaccination. This study aims to assess vaccine-related perceptions and behaviors among these student populations in an Italian university. Methods: A cross-sectional survey was conducted between November 2022 and February 2024 at the University of Rome “Tor Vergata”. A structured, anonymous questionnaire, including the Vaccination Attitudes Examination (VAX) scale, vaccine knowledge items, and sources of information, was administered to students in nursing (n = 205), pediatric nursing (n = 46), and midwifery (n = 21). Statistical analyses included descriptive statistics, ANOVA, post hoc tests, and Mann–Whitney U tests. Results: Among the 272 participants, 20.6% reported refusing at least one recommended vaccine, and 18.4% delayed vaccination for non-medical reasons. Vaccine knowledge and confidence increased significantly with academic progression (p < 0.001). Midwifery students showed both the highest concern for long-term vaccine effects and the greatest confidence in vaccine safety. Institutional and scientific sources were the most trusted, though traditional and non-institutional media also influenced perceptions, particularly among midwifery students. Conclusions: Despite high COVID-19 vaccine uptake, VH persists among health professional students. Discipline-specific patterns highlight the need for early, targeted educational strategies to enhance vaccine literacy and reduce hesitancy. Tailored training may empower future professionals to become informed and credible advocates for vaccination. Full article
(This article belongs to the Special Issue Acceptance and Hesitancy in Vaccine Uptake: 2nd Edition)
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15 pages, 236 KiB  
Article
Multifaceted Determinants of Varicella Vaccination Uptake Among Children Aged 1–10 Years in China: Findings of a Population-Based Survey Among 996 Parents
by Weijun Peng, Yuan Fang, Hongbiao Chen, Minjie Zhang, Yadi Lin and Zixin Wang
Vaccines 2025, 13(8), 810; https://doi.org/10.3390/vaccines13080810 - 30 Jul 2025
Viewed by 472
Abstract
Background/Objectives: Chickenpox is an ongoing health threat for young children. This study aimed to investigate varicella vaccination uptake among children and its determinants at both the individual and interpersonal levels. Methods: A cross-sectional survey of parents of children aged 0–15 years and with [...] Read more.
Background/Objectives: Chickenpox is an ongoing health threat for young children. This study aimed to investigate varicella vaccination uptake among children and its determinants at both the individual and interpersonal levels. Methods: A cross-sectional survey of parents of children aged 0–15 years and with administrative health records was conducted between September and October 2024 in Shenzhen, China. Participants were recruited through multistage random sampling. This analysis was based on a subsample of 996 parents whose children were 1–10 years old and without a prior history of chickenpox. Multivariate logistic regression models were fitted. Results: Among the participants, 47.0% reported that their children had received a varicella vaccination. Parents who believed that chickenpox was highly contagious (adjusted odds ratios [AOR]: 1.62, 95% confidence interval [CI]: 1.23, 2.13), perceived more benefits (AOR: 1.22, 95% CI: 1.05, 1.41) and cues to action (AOR: 1.33, 95% CI: 1.04, 1.69), and exhibited greater self-efficacy (AOR: 1.40, 95% CI: 1.09, 1.80) related to children’s varicella vaccination reported higher varicella vaccination uptake for their children. Greater perceived barriers related to vaccination (AOR: 0.89, 95% CI: 0.83, 0.95) and dysfunctional interactions with children (AOR: 0.97, 95% CI: 0.94, 0.99) were associated with lower varicella vaccination uptake for children. In addition, higher exposure to information encouraging parents to vaccinate their children against chickenpox (AOR: 1.24, 95%CI: 1.08, 1.41) and thoughtful consideration of the veracity of the information were associated with higher varicella vaccination uptake among children (AOR: 1.19, 95% CI: 1.05, 1.36). Conclusions: There is a strong need to promote varicella vaccination for children in China. Full article
(This article belongs to the Special Issue Acceptance and Hesitancy in Vaccine Uptake: 2nd Edition)
13 pages, 252 KiB  
Article
Perspectives of Healthcare Students on Childhood Vaccines: Insights from a Cross-Sectional Study in Bulgaria
by Maria Rohova, Nikolay L. Mihaylov, Antoniya Dimova and Rouzha Pancheva
Vaccines 2025, 13(8), 804; https://doi.org/10.3390/vaccines13080804 - 29 Jul 2025
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Abstract
Background/Objectives: Medical and nursing students, as future healthcare professionals, influence public trust and vaccine acceptance. Knowledge gaps or misconceptions regarding immunization may undermine their confidence and effectiveness in addressing vaccine hesitancy. This study explores perceptions and attitudes toward childhood vaccination among Bulgarian healthcare [...] Read more.
Background/Objectives: Medical and nursing students, as future healthcare professionals, influence public trust and vaccine acceptance. Knowledge gaps or misconceptions regarding immunization may undermine their confidence and effectiveness in addressing vaccine hesitancy. This study explores perceptions and attitudes toward childhood vaccination among Bulgarian healthcare students and factors shaping these outcomes. Methods: A cross-sectional survey was conducted in 2024, using an online self-administered questionnaire completed by 374 medical and nursing students. Descriptive statistics were used to analyze vaccine-related responses, comparing attitudes between healthcare programs and education years. Binomial logistic regression was applied to identify predictors of support for mandatory vaccination, first considering demographic and academic variables, and then adding students’ beliefs and common misconceptions. Results: Medical students showed more positive attitudes toward vaccination than nursing students, with 96.8% of medical students versus 89.4% of nursing students believing vaccines are effective (p = 0.005). Students in advanced years demonstrated stronger belief in vaccine effectiveness (p = 0.038). Additionally, misbeliefs about the measles vaccine causing autism decreased significantly, with most students in higher years rejecting this misconception (p = 0.009). Logistic regression revealed that belief in following the vaccine schedule (OR = 22.71; p < 0.001) and confidence in vaccine effectiveness (OR = 10.20; p < 0.001) were the strongest predictors of support for mandatory vaccination, with attitudinal factors explaining over half of the variance. Conclusions: Healthcare students’ attitudes about vaccination influence public health outcomes, as their perspectives reflect experience and beliefs. Targeted vaccine education helps address misconceptions and improve vaccination rates. Full article
(This article belongs to the Special Issue Acceptance and Hesitancy in Vaccine Uptake: 2nd Edition)
11 pages, 585 KiB  
Article
Vaccination Status and Influencing Factors of Delayed Vaccination in Toddlers Born to Hepatitis B Surface Antigen-Positive Mothers
by Jinling Gao, Lin Luan, Yiheng Zhu, Jie Zhu, Zhiyuan Zhu, Tian Gong, Juan Xu and Na Liu
Vaccines 2025, 13(3), 286; https://doi.org/10.3390/vaccines13030286 - 7 Mar 2025
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Abstract
Background: This study aims to analyze the vaccination status and factors influencing delayed vaccination among toddlers born to hepatitis B surface antigen (HBsAg)-positive mothers. Methods: Data of HBsAg-positive mothers between 1 January 2021 and 31 December 2022 were provided by the [...] Read more.
Background: This study aims to analyze the vaccination status and factors influencing delayed vaccination among toddlers born to hepatitis B surface antigen (HBsAg)-positive mothers. Methods: Data of HBsAg-positive mothers between 1 January 2021 and 31 December 2022 were provided by the Suzhou Maternal and Child Health Care and Family Planning Service Center. The vaccination records were obtained from the Jiangsu Province Immunization Service Management Information System. Logistic regression analysis was used to analyze influencing factors of delayed vaccination. Results: A total of 4250 toddlers born to HBsAg-positive mothers were documented. The data revealed that the first dose of the hepatitis B vaccine was administered to 100% of the toddlers. In addition, the coverage of the National Immunization Program (NIP) vaccines among these toddlers ranged from 92.9% to 99.4%. The proportion of delayed NIP vaccination varied between 0% and 12.2%. The proportion of delayed Bacillus Calmette–Guérin (BCG) vaccination was 11.3%, with the delay predominantly observed between 4 and 6 months. Notably, the proportion of delayed BCG vaccination among the toddlers born to HBsAg-positive mothers was significantly higher than that in the general population. Additionally, the proportion of the first dose of non-NIP vaccines was 3.3–36.4%, and the proportion of DTaP-IPV/Hib was 27.0%. Logistic regression analysis revealed that the regional level, the mother’s human papillomavirus (HPV) vaccination status, and the infant’s birth weight were significant factors influencing the timeliness of vaccination. Conclusions: Although the vaccination status of toddlers born to HBsAg-positive mothers in Suzhou city remains stable, the issue of delayed vaccination requires attention. It is essential to continue strengthening targeted vaccine education to reduce vaccine hesitancy and improve the rate of timely vaccination. Full article
(This article belongs to the Special Issue Acceptance and Hesitancy in Vaccine Uptake: 2nd Edition)
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13 pages, 529 KiB  
Article
Vaccination Coverage and Attitudes in Children and Adults on Biologic Therapies: Cocooning Strategies, Undervaccination Factors and Predictors of Favorable Attitudes
by Charikleia Kariniotaki, George Bertsias, Emmanouil Galanakis and Chrysoula Perdikogianni
Vaccines 2025, 13(2), 152; https://doi.org/10.3390/vaccines13020152 - 1 Feb 2025
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Abstract
Background: Infections pose a significant risk of morbidity and mortality to patients on biologics, with the vaccination of both patients and their close contacts serving as a key preventive measure. Despite its importance, there are limited data on the vaccination coverage for this [...] Read more.
Background: Infections pose a significant risk of morbidity and mortality to patients on biologics, with the vaccination of both patients and their close contacts serving as a key preventive measure. Despite its importance, there are limited data on the vaccination coverage for this group, and no studies have examined the vaccination status of patients’ close contacts. Objectives: To assess vaccination rates among patients on biologics and their household contacts, identifying reasons for inadequate vaccination and examining factors influencing vaccination status and attitudes is crucial. Methods: A cross-sectional study was conducted from September 2022 to February 2023 at the two hospitals in Heraklion, Crete, including adult and pediatric patients on biologics. Data were collected through medical records and interviews and analyzed using Microsoft Excel 2016 and MedCalc2006. Results: Among the 446 adults, vaccination rates were as follows: 83% for COVID-19, 73.8% for influenza, 64.5% for the pneumococcal conjugate vaccine, 29.6% for the pneumococcal polysaccharide vaccine, and 4% for Tdap. Among the 26 children included, those with basic immunization schedule coverage exceeded 96%, but rates for the vaccines usually administered at adolescence were lower (Tdap: 47.8%, HPV: 42.1%, MenACWY: 66.7%). COVID-19 vaccination was at 38.5%. Regarding the additional vaccines recommended due to treatment-induced immunosuppression, 69.2% of pediatric patients received the annual influenza vaccine, while only 19.2% received the pneumococcal polysaccharide vaccine. Household contacts demonstrated low vaccination rates (<59%), except for COVID-19 (81%). Female gender (p < 0.007) and older age (by 1 year, p < 0.001) were associated with favorable attitudes and higher coverage in adults, while in pediatric patients, no statistically significant associations were found. A lack of physician recommendation was the primary reported reason for not being vaccinated. Conclusions: Significant vaccination gaps exist among patients on biologics and their close contacts, largely due to inadequate physician recommendations. Raising awareness and strengthening healthcare provider roles are essential to improve coverage in this high-risk group. Full article
(This article belongs to the Special Issue Acceptance and Hesitancy in Vaccine Uptake: 2nd Edition)
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19 pages, 2347 KiB  
Systematic Review
Addressing Vaccine Hesitancy in College Students Post COVID-19 Pandemic: A Systematic Review Using COVID-19 as a Case Study
by Wai Yan Min Htike, Muxuan Zhang, Zixuan Wu, Xinyu Zhou, Siran Lyu and Yiu-Wing Kam
Vaccines 2025, 13(5), 461; https://doi.org/10.3390/vaccines13050461 - 25 Apr 2025
Viewed by 1241
Abstract
Background: Resistance to vaccinations continues to pose a considerable challenge to attaining widespread vaccination, especially among the college student demographic, who are pivotal in championing public health initiatives. This systematic review investigates the elements that influence reluctance to receive the COVID-19 vaccine [...] Read more.
Background: Resistance to vaccinations continues to pose a considerable challenge to attaining widespread vaccination, especially among the college student demographic, who are pivotal in championing public health initiatives. This systematic review investigates the elements that influence reluctance to receive the COVID-19 vaccine among university students globally. Utilizing the WHO’s 3C model, which encompasses confidence, complacency, and convenience, this review seeks to pinpoint the main factors and suggest focused strategies to address them. Methods: Following the PRISMA guidelines, we conducted a systematic search in PubMed, Medline, Web of Science, Scopus, Embase, and Global Health. Eligible studies were cross-sectional, peer-reviewed, and examined COVID-19 vaccine hesitancy among college students. Covidence was used for screening, and data were synthesized narratively using the 3C model. Results: Sixty-seven studies (n = 88,345 participants) from 25 countries were included in this study. Confidence factors were the most influential, with fear of side effects (87.18%) and doubts about efficacy (72.4%) as primary concerns. Complacency factors included a low perceived risk of infection (34.9%) and a preference for alternative preventive measures (52.3%). Convenience barriers involved financial costs (58.1%) and difficulty accessing vaccination centers (40.3%). Subgroup analyses revealed variations by academic discipline and geographic region, with medical students showing hesitancy despite their health knowledge. Conclusions: COVID-19 vaccine hesitancy among college students is primarily driven by safety concerns, misinformation, and accessibility barriers. Addressing hesitancy requires transparent risk communication, policy-driven accessibility improvements, and tailored educational interventions. These findings can inform strategies to enhance vaccine uptake among young adults and contribute to broader efforts in pandemic preparedness. Full article
(This article belongs to the Special Issue Acceptance and Hesitancy in Vaccine Uptake: 2nd Edition)
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