Internal and external factors affecting vaccination coverage: Modeling the interactions between vaccine hesitancy, accessibility, and mandates

Abstract

Society, culture, and individual motivations affect human decisions regarding their health behaviors and preventative care, and health-related perceptions and behaviors can change at the population level as cultures evolve. An increase in vaccine hesitancy, an individual mindset informed within a cultural context, has resulted in a decrease in vaccination coverage and an increase in vaccine-preventable disease (VPD) outbreaks, particularly in developed countries where vaccination rates are generally high. Understanding local vaccination cultures, which evolve through an interaction between beliefs and behaviors and are influenced by the broader cultural landscape, is critical to fostering public health. Vaccine mandates and vaccine inaccessibility are two external factors that interact with individual beliefs to affect vaccine-related behaviors. To better understand the population dynamics of vaccine hesitancy, it is important to study how these external factors could shape a population’s vaccination decisions and affect the broader health culture. Using a mathematical model of cultural evolution, we explore the effects of vaccine mandates, vaccine inaccessibility, and varying cultural selection trajectories on a population’s level of vaccine hesitancy and vaccination behavior. We show that vaccine mandates can lead to a phenomenon in which high vaccine hesitancy co-occurs with high vaccination coverage, and that high vaccine confidence can be maintained even in areas where access to vaccines is limited.

Analysis of Attitudes and Practices towards the Influenza Vaccine in High-Risk Adults in Poland

“…The low level of vaccination coverage thus indicates a low level of public awareness of the dangers of not being vaccinated. This may also mean that the public does not understand the benefits of vaccination, which, in turn, may result from a lack of health education and health promotion [ 18 ]. The situation is even more serious as we know that the world is still struggling with the current SARS-CoV-2 virus, which may result in additional health burdens [ 19 ].…”

Indirect Effects of the COVID-19 Pandemic on Routine Childhood Vaccination in Low-Income Countries: A Systematic Review to Set the Scope for Future Pandemics

“…Even in countries that had widespread access to the COVID-19 vaccine, other routine vaccinations slipped, leaving children at risk for preventable diseases [ 9 ]. A multitude of factors contribute to reductions in vaccination coverage, including local vaccination culture, vaccine hesitancy, and vaccine mandates, as well as access to care and adequate vaccine supply [ 11 ]. Vaccination coverage started to recover in 2022 when DTP 3 vaccine coverage increased to 84% globally (Africa = 72%, Americas = 83%, Eastern Mediterranean = 84%, Europe = 94%, South East Asia = 91%, and Western Pacific = 93%) [ 12 ].…”