Vaccine hesitancy, refusal and access barriers: The need for clarity in terminology

Although vaccination uptake is high in most countries, pockets of sub-optimal coverage remain, posing a threat to individual and population immunity. Increasingly, the term ‘vaccine hesitancy’ is being used by experts and commentators to explain sub-optimal vaccination coverage. The authors contend that using this term to explain all partial or non-immunization risks generating solutions that are a poor match for the problem in a particular community or population. The authors propose more precision in the term ‘vaccine hesitancy’ is needed, particularly since much under-vaccination arises from factors related to access or pragmatics.