Influenza vaccine hesitancy is a significant threat to global efforts to reduce the burden of seasonal and pandemic influenza. Potential barriers of influenza vaccination need to be identified to inform interventions to raise awareness, influenza vaccine acceptance and uptake. This review aims to 1 identify relevant studies and extract individual barriers of seasonal and pandemic influenza vaccination for risk groups and the general public; and 2 map knowledge gaps in understanding influenza vaccine hesitancy to derive directions for further research and inform interventions in this area.
Thirteen databases covering the areas of Medicine, Bioscience, Psychology, Sociology and Public Health were searched for peer-reviewed articles published between the years and Following the PRISMA approach, articles were selected and analyzed for significant barriers to influenza vaccine uptake or intention.
The barriers for different risk groups and flu types were clustered according to a conceptual framework based on the Theory of Planned Behavior and discussed using the 4C model of reasons for non-vaccination. Most studies were conducted in the American and European region. Health care personnel HCP and the general public were the most studied populations, while parental decisions for children at high risk were under-represented.
This study also identifies understudied concepts. A lack of confidence, inconvenience, calculation and complacency were identified to different extents as barriers to influenza vaccine uptake in risk groups. Many different psychological, contextual, sociodemographic and physical barriers that are specific to certain risk groups were identified.
(mh=QYVfQths3iPM_EBh)0.jpg "Prostitutes in Mexico City")
While most sociodemographic and physical variables may be significantly related to influenza vaccine hesitancy, they cannot be used to explain its emergence or intensity.
