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What Public Health Professionals Should Know About Vaccine Hesitancy

Here’s what public health professionals should know about vaccine concerns and hesitancy.

The COVID-19 pandemic has brought more attention to a decades long public health issue: vaccine hesitancy. Opinions and concerns about vaccinations are particularly strong when it comes to children. And though 72% of adults support the universal immunization of children,1 hesitancy still persists. The history and reasons behind vaccine hesitancy are varied and warrant closer inspection by public health professionals who wish to address public health challenges and improve global health outcomes.


A History of Vaccine Hesitancy
Vaccine hesitancy is not a new phenomenon. Hesitancy toward vaccines has existed since their introduction. For instance, the smallpox vaccine—the first successful vaccine for an infectious disease—was met with much skepticism and opposition. Around the early 1800s, opponents of the smallpox vaccine believed there were negative connotations associated with injecting material taken from a cow into humans. They also questioned whether it was right for a vaccine to interfere with the “divine will” they believed to cause disease and the perceived infringement upon individual freedom.2 Despite these concerns, the disease was successfully eradicated due to a worldwide smallpox immunization program. However, public health professionals have seen vaccine hesitancy continue into the future, for similar and growing reasons.

Reasons Behind Vaccine Hesitancy
There are a number of reasons behind vaccine refusal and hesitancy in the U.S. According to a 2016 report by Statista Research Department, the most common reasons given to healthcare professionals by families are fear of connection to autism spectrum disorder (77%), concerns about added ingredients in vaccines (71%), and worry a child will suffer other complications from a vaccine (70%).3 Some of these reasons can be attributed to the public’s instant access to information—and misinformation. Growing mistrust of large corporations that manufacture vaccines and the relationship between the pharmaceutical industry and the government is also frequently cited. Some individuals would rather potentially face known risks—like the consequences of a specific disease—versus the unknown risks they associate with vaccines. This is referred to as ambiguity aversion.2 Other reasons cited include, but aren’t limited to:

  • Distrust in science and medical communities.2
  • Growing interest in “natural” products and alternative medicine.2
  • Worry vaccines will “overwhelm” an infant’s immune system.3
  • Religious or political beliefs.3

In 2021, the Delphi Research Group partnered with Facebook to conduct a vaccine hesitancy survey amid the COVID-19 pandemic. With responses from more than 1.9 million Americans, they found that 23% of survey respondents remained hesitant about receiving a COVID-19 vaccine, with 70% of that group citing side effects as the main issue guiding their hesitancy.4

Vaccination Laws
To safeguard population health, all 50 U.S. states have legislation in place that requires a child to receive specific vaccinations before they can attend school. However, nonmedical vaccination exemptions are permitted on a state-by-state basis. Currently, 44 states and Washington, D.C., allow religious exemptions, and 15 states allow philosophical exemptions.5 Therefore, individuals who cite religious and/or moral, personal, or other beliefs as their reason for vaccine hesitancy or refusal are legally protected depending upon their state residence. For children who are immunocompromised, are allergic to vaccines or their ingredients, or have medical contraindications, all 50 states permit exemptions.5

As of 2019, the World Health Organization listed vaccine hesitancy as a top threat to global health.6

Become a Global Health Leader When You Earn Your Master of Public Health at Walden University

In Walden’s Master of Public Health (MPH) degree program, you will have access to a robust curriculum featuring case studies on the latest public health issues and trends in a cutting-edge online environment. Whether you want to pursue a public health career in education, policymaking, administration, or research, Walden’s MPH program can give you the academic preparation you need. And at Walden—an accredited university—you can earn your public health degree online, so you can take classes at whatever time of day works best for you as you work toward your master’s and prepare to impact community health.

Walden University is an accredited institution offering a suite of public health degree programs online, including a Master of Public Health (MPH) degree program. Expand your career options and earn your degree using a convenient, flexible learning platform that fits your busy life.


Note on Accreditation
The Council on Education for Public Health (CEPH) Board of Councilors acted at its September 6, 2019, meeting to accredit the Master of Public Health (MPH) Program at Walden University for a five-year term, based on an application for accreditation submitted on February 3, 2018. On June 5, 2020, the CEPH Board of Councilors accredited the Doctor of Public Health (DrPH) at Walden University, after reviewing an accreditation application submitted on April 21, 2020. CEPH is an independent agency recognized by the U.S. Department of Education to accredit schools of public health and programs of public health. CEPH accreditation provides assurance that the program has been evaluated and met accepted public health profession standards in practice, research, and service. For a copy of the final self-study document and/or final accreditation report, please contact the dean of the College of Health Sciences and Public Policy ([email protected]).

Note on Certification
The National Board of Public Health Examiners (NBPHE) offers the Certified in Public Health (CPH) credential as a voluntary core credential for public health professionals. As the eligibility criteria may change periodically, students should visit for more information about certification in public health. It is the individual’s responsibility to understand, evaluate, and comply with all requirements relating to national certification. Walden makes no representations or guarantees that completion of Walden coursework or programs will permit an individual to obtain national certification or practice as a public health professional in the state where they intend to practice.

Walden University is accredited by The Higher Learning Commission,