Trends in classifying vaccine hesitancy reasons reported in the WHO/UNICEF Joint Reporting Form, 2014–2017: Use and comparability of the Vaccine Hesitancy Matrix

ABSTRACT

Since 2014, the World Health Organization (WHO) member states have been annually reporting vaccine hesitancy reasons, using the WHO/UNICEF Joint Reporting Form (JRF). The Vaccine Hesitancy Matrix (VHM), developed by a WHO strategic advisory group of experts, can serve as an important tool to categorize vaccine hesitancy reasons reported in the JRF. We aimed to describe the reasons for vaccine hesitancy reported globally from 2014 to 2017 to ascertain trends over time and understand the comparability of using the VHM to classify hesitancy reasons from 2014 to 2016 based on previously published literature. We conducted a quantitative content analysis to code and categorize vaccine hesitancy reasons reported in the JRF from 2014 to 2017. Vaccine hesitancy trends were consistent from 2014 to 2017, where vaccine hesitancy reasons were mainly related to “individual and group level influences” (59%) followed by “contextual influences” (25%), and “vaccine- or vaccination-specific issues” (16%). Comparability of our approach to categorize vaccine hesitancy to the previously published JRF data showed that results were mostly but not entirely consistent. Major differences in categorizing vaccine hesitancy were noted between two specific reasons – “experience with past vaccination” (under “individual and group influences”) and “risk/benefit- scientific evidence” (under “vaccine and vaccination-specific issues”); this was usually due to lack of clear definitions in some sub-categories and generic responses reported in the JRF. The JRF hesitancy module may benefit from modifications to improve the data quality. Understanding global vaccine hesitancy is crucial and JRF can serve as an important tool, especially with the potential introduction of a COVID-19 vaccine.

KEYWORDS:

• Joint Reporting Form (JRF)
• vaccine Hesitancy
• vaccine demand
• immunization trends

Acknowledgments

We greatly appreciate Sarah Lane and Dr. Noni MacDonald for sharing the numeric data from their 2018 article that allowed us to accurately compare our JFR findings with their results for the comparability analysis presented here.

Contributions

MFJ conceptualized the analysis. SK and BH coded the data with supervision by MFJ. SK analyzed the data with support from MJF. DP contributed to the interpretation of the results. SK and MFJ led the writing of the manuscript with contributions from DP and BH. All authors approved the final version of this manuscript.

Ethical approval

Not required due to non-involvement of human subjects.

Disclosure of potential conflicts of interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Data sharing

All data used in the analysis are publicly available from the WHO website.

Disclaimer

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the U.S. Centers for Disease Control and Prevention.

Supplementary Material

Supplemental data for this article can be accessed on the publisher’s website.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.