Unpacking Vaccine Hesitancy Among Healthcare Providers

Vaccine hesitancy – which refers to “delays in acceptance or refusal these practitioners can actually address the fears of their vaccineof vaccination despite availability of vaccination services” – is a growing concern worldwide (MacDonald and SAGE Working Group on Vaccine Hesitancy, 2015). Vaccine hesitancy is increasingly being recognized as a barrier to immunization program success and healthcare providers are known to play a crucial role in fostering vaccine acceptance among the vaccine-hesitant (Leask et al., 2014). Healthcare providers are expected to be knowledgeable about the risks and benefits of vaccination, the risks of vaccine preventable diseases and to be able to communicate this information well to their patients. In this issue of EBioMedicine, Verger et al. present the findings of a questionnaire study of vaccination practices and attitudes among general practitioners in France (Verger et al., 2015). Up to 43% of the surveyed practitioners were not recommending vaccination to their target patients which, as noted by the authors, is a proxy for the practitioners own vaccine hesitancy. Many respondents disagreed with statements about the safety and usefulness of vaccines and a strong association between practitioners' reported recommendations and their own vaccination behavior was found (Verger et al., 2015). These findings underline a major barrier in addressing vaccine hesitancy: many healthcare providers are themselves vaccine-hesitant and therefore are unlikely to dispel their patients' concerns and doubts about vaccination. Vaccine hesitancy among healthcare providersmust be addressed as studies in high, middle and limited resource settings consistently have shown that the majority of parents look to their child's healthcare provider for information and advice on vaccine-preventable diseases, vaccines and the recommended schedule (Wheeler and Buttenheim, 2013; Favin et al., 2012). When providers are able to communicate effectively with parents about vaccine benefits and risks, the value and need for vaccinations and vaccine safety, parents are more confident in their decision (Opel et al., 2013). However, to do this well, providers need to be confident themselves about the safety, effectiveness and importance of vaccination. Previous studies have shown a strong association between healthcare providers' knowledge and attitudes about vaccines, their recommendations of vaccines to their patients and the vaccine uptake of their patients (Zhang et al., 2012). Although the majority of practitioners surveyed in Verger et al. study felt confident in their ability to explain vaccine utility and safety to their patients, many also held negative beliefs regarding vaccination (Verger et al., 2015). Thus the concern raised by the authors about how effectively