Vaccination hesitation and refusal in countries with universal health systems: an integrative review about their effects

Abstract

The number of individuals who refuse or hesitate to be vaccinated has been increasing in recent years in several countries, which can be noted with the decrease in vaccination coverage. Given this scenario of increasing vaccine refusal/ hesitancy, it is necessary to know what effects these phenomena have brought to universal health systems. This study aims to review the effects of vaccine refusal/ hesitancy for the population of countries with universal health care systems, in the scientific production in the health field. An integrative review was conducted in the Lilacs, SciELO, PubMed/Medline, Scopus, and Embase databases. There were
318 publications, systematized and ordered review was performed, remaining 12 scientific articles. Seven categories to approach the topic were identified: 1) public policies for the immunization of the population, 2) factors of hesitation in influenza vaccination, 3) hesitation among health professionals, 4) important factors for the parents’ decision to vaccinate, 5) vaccine safety, 6) social, demographic, and economic determinants for hesitation/refusal and 7) projection of vaccination coverage for the future and vaccination policy. The articles studied allowed us to understand how vaccine refusal and hesitancy occur in different scenarios, their effects, and how these reasons are interconnected with each other.