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July 2025 Influenza Guide for PharmacistsVolume
Moving the Needle From Vaccine Hesitancy to Vaccine Acceptance
Author(s):
Key Takeaways
- Vaccination has saved millions of lives, yet vaccine hesitancy remains a significant global health threat, fueled by misinformation and systemic barriers.
- Health care providers, including pharmacists, are pivotal in combating vaccine hesitancy by providing accurate information and addressing patient concerns empathetically.
Many factors contribute to vaccine skepticism, including trust, convenience, and fear.
Experts estimate that vaccination has saved approximately 154 million lives globally since 1974, with the vast majority being children younger than 5 years.1 The Vaccines for Children (VFC) Program helped prevent roughly 508 million cases of vaccine-preventable illnesses in children born between 1994 and 2023.2 In addition, VFC prevented more than 32 million hospitalizations and 1.1 million premature deaths.2
Image Credit: Drazen | stock.adobe.com
Rates of influenza infection remain a significant public health concern, particularly because vaccination rates often fall short of recommended levels. For instance, flu vaccination rates for adults have historically ranged from 30% to 60%, much lower than the suggested 70% target.3 This gap is exacerbated by vaccine hesitancy, which plays a critical role in low uptake. This hesitancy can lead to delayed vaccination or outright refusal, directly impacting population-level immunity and increasing the risk of widespread influenza outbreaks and associated complications.4
Vaccine Hesitancy
Vaccine hesitancy—reluctance or refusal to receive immunizations for preventable infectious diseases—is on the list of the top 10 global health threats.5,6 And pharmacists and pharmacy technicians are perfectly suited to offer guidance and sound information on vaccination’s benefits.6
Many factors influence and contribute to vaccine hesitancy, including confidence and/or trust in the vaccine and vaccinator, convenience, and risk of disease.2 Concerns over the credibility of vaccines and disease information and the patient’s behavioral, religious, and social beliefs that encompass a broad continuum of views can also influence the decision process.7 Additional barriers include fear of vaccines, lack of believable information, systemic obstacles such as cost and drug storage, and vaccine accessibility.8 In addition, some people simply fail to prioritize vaccinations.8
I Saw It on the Internet...
Online influencers can also magnify or exaggerate misinformation about vaccines and public health. Rather than discussing concerns with credible health care providers, individuals and parents often seek information about vaccines on the internet. Vaccine misinformation campaigns and influencers fuel vaccine hesitancy and anxiety, threatening gains in vaccine acceptance and coverage.
In a recent study, researchers were surprised at their results after mapping the online clustering of nearly 100 million Facebook users who expressed vaccine-related views. Although fewer in number, antivaccination clusters wielded greater influence than provaccination clusters, connecting proactively with undecided individuals to create new, rapidly growing clusters. Their nuanced narratives mixed multiple vaccine concerns; provaccination clusters tended not to mix messages.9
Current Perceptions on Vaccination
In an August 2024 Gallup poll, only 40% of Americans stated that childhood vaccination is “important,” representing a 24% decrease since 2001. During the same time period, those believing childhood vaccination to be “extremely important” or “very important” have had a combined decrease from 94% to 69%.10
The Canadian PIVOT-I study assessed whether intervention by a health care provider or clinician would effectively change parental beliefs and behaviors toward vaccination. Investigators aimed to increase uptake of the adjuvanted trivalent influenza vaccine among pediatric patients aged 6 to 23 months. The study revealed that after brief educational meetings with a clinical partner, 73% of parents felt influenza vaccines were safe. Moreover, parental views on vaccine efficacy and importance reached nearly 70%. With support from significant others (62.8%) and clinical providers (82%), more than 66% of parents intended to vaccinate their infants.11
Provider-Led Strategies to Increase Childhood Vaccination Rates
A recent study evaluated whether providing pharmacists with information and skills-based knowledge to promote pneumococcal vaccination would increase patient vaccine uptake. The results found that after educational training, pharmacists delivered information that encouraged vaccination more effectively, and patients were more apt to receive the vaccine at the time of their conversations.12 Additional strategies for increasing vaccine uptake are listed in Table 1.8,13
Table 1
Counseling Patients With Motivational Interviewing
Motivational interviewing improves adherence by acknowledging patients’ internal desires and understanding their wishes regarding vaccination. It employs techniques such as active listening, open-ended questioning, asking permission to fill in knowledge gaps, and recognizing individualism. These establish a mutual understanding between patient and provider.5
A 2021 study of more than 30,000 adolescent patients in Colorado used motivational interviewing to increase acceptance and receipt of the human papillomavirus (HPV) vaccine. By the end of the study, 9.5% more minors had started HPV vaccination, and 4.5% more completed the vaccine series.5
Additional strategies exist to combat vaccine hesitancy, alleviate patient concerns, and successfully move the needle from vaccine hesitancy to vaccine acceptance (Table 2).8,9
Table 2
Conclusion
Health care providers play a crucial role in maintaining a healthy society and can share their knowledge within their communities. By consistently providing accurate information to patients and parents regarding the significance of vaccination, they can transform negative preconceptions into positive perspectives. Pharmacists and pharmacy technicians can effectively reduce vaccine hesitancy by addressing patient concerns with empathy and professionalism.
REFERENCES
Shattock AJ, Johnson HC, Sim SY, et al. Contribution of vaccination to improved survival and health: modelling 50 years of the Expanded Programme on Immunization. Lancet. 2024;403(10441):2307-2316. doi:10.1016/S0140-6736(24)00850-X
Zhou F, Jatlaoui TC, Leidner AJ, et al. Health and economic benefits of routine childhood immunizations in the era of the Vaccines for Children Program – United States, 1994-2023. MMWR Morb Mortal Wkly Rep. 2024;73(31):682-685. doi:10.15585/mmwr.mm7331a2
Flu vaccination coverage, United States, 2023-24 influenza season. CDC. September 20, 2024. Accessed May 29, 2025. https://www.cdc.gov/fluvaxview/coverage-by-season/2023-2024.html
Kumar S, Shah Z, Garfield S. Causes of vaccine hesitancy in adults for the influenza and COVID-19 vaccines: a systematic literature review. Vaccines (Basel). 2022;10(9):1518. doi:10.3390/vaccines10091518
Limaye RJ, Opel DJ, Dempsey A, et al. Communicating with vaccine-hesitant parents: a narrative review. Acad Pediatr. 2021;21(4S):S24-S29. doi:10.1016/j.acap.2021.01.018
Shen AK, Tan ASL. Trust, influence, and community: why pharmacists and pharmacies are central for addressing vaccine hesitancy. J Am Pharm Assoc (2003). 2022;62(1):305-308. doi:10.1016/j.japh.2021.10.001
Tuckerman J, Kaufman J, Danchin M. Effective approaches to combat vaccine hesitancy. Pediatr Infect Dis J. 2022;41(5):e243-e245. doi:10.1097/INF.00000000003499
Ventola CL. Immunization in the United States: recommendations, barriers, and measures to improve compliance. P T. 2016;41(8):492-497.
Daley MF, Glanz JM. Using social media to increase vaccine acceptance. Acad Pediatr. 2021;21(4S):S32-S33. doi:10.1016/j.acap.2020.10.018
Jones JM. Far fewer in U.S. regard childhood vaccinations as important. Gallup. August 7, 2024. Accessed May 29, 2025. https://news.gallup.com/poll/648308/far-fewer-regard-childhood-vaccinations-important.aspx
Fisher WA, Gilca V, Murti M, et al. Parental attitudes and perceptions of support after brief clinician intervention predict intentions to accept the adjuvanted seasonal influenza vaccination: findings from the Pediatric Influenza Vaccination Optimization Trial (PIVOT)-I. Vaccines (Basel). 2022;10(11):1957. doi:10.3390/vaccines10111957
Ramrattan D, Nagy D, Eurich D, Hughes C, Lau D, Simpson S. Changing the conversation: empowering community pharmacists to address pneumococcal vaccine hesitancy. J Am Pharm Assoc (2003). 2024;64(6):102202. doi:10.1016/j.japh.2024.102202
Rand CM, Humiston SG. Provider focused interventions to improve child and adolescent vaccination rates. Acad Pediatr. 2021;21(4S):S24-S39. doi:10.1016/j.acap.2021.02.014
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