Indian Journal of Public Health

LETTER TO EDITOR
Year
: 2019  |  Volume : 63  |  Issue : 2  |  Page : 160-

Vaccine hesitancy for childhood vaccinations in slum areas of Siliguri: A critical commentary


Vinu Cherian 
 Assistant Professor, Department of Community Medicine, Dr. Somervell Memorial CSI Medical College, Thiruvananthapuram, Kerala, India

Correspondence Address:
Vinu Cherian
Department of Community Medicine, Dr. Somervell Memorial CSI Medical College, Thiruvananthapuram - 695 504, Kerala
India




How to cite this article:
Cherian V. Vaccine hesitancy for childhood vaccinations in slum areas of Siliguri: A critical commentary.Indian J Public Health 2019;63:160-160


How to cite this URL:
Cherian V. Vaccine hesitancy for childhood vaccinations in slum areas of Siliguri: A critical commentary. Indian J Public Health [serial online] 2019 [cited 2022 Sep 25 ];63:160-160
Available from: https://www.ijph.in/text.asp?2019/63/2/160/260605


Full Text



Sir,

I read with great interest the article dealing with vaccine hesitancy by Dasgupta et al.[1] Their work is an important contribution to this growing area of research.

However, I would like to point out certain concerns regarding the methodology of this study, which may help to guide the design of future studies on this topic.

First, the main outcome, i.e., vaccine hesitancy, was calculated using the immunization card, and vaccine hesitancy was considered absent for those who had completed the required vaccines. The immunization card cannot be used as a sole indicator to measure vaccine hesitancy as it does not take into account those parents who have concerns and doubts about vaccines yet follow the recommended schedule. A vaccine-hesitant caregiver may be reluctant, but still accept one or more vaccines.[2]

Second, the authors defined vaccine delay as the prolongation of any dose beyond 14 days of the recommended time of vaccination. The WHO recognizes children who have received all vaccinations within 4 weeks from the recommended schedule as being fully and timely vaccinated.[3] A delay of 14 days is too short to be used as the operational definition for someone to be vaccine hesitant as there may be personal reasons behind such a delay, especially following an event such as the birth of a baby, which carries with it numerous sociocultural connotations.

Hence, the fact that Bacille Calmette Guerin (BCG) vaccine is a birth dose combined with the short operational definition of delay used in this study may have contributed to the exaggerated prevalence of vaccine delay for BCG obtained by the authors. Incidentally, the maximum delay obtained in this study among all the vaccines was for BCG, and this may be a spurious finding for the reasons listed above.

Third, if someone forgets the date for immunization, is he/she actually vaccine hesitant? Forgetfulness regarding the next dose of vaccine may be a reason for delay in vaccination but should be excluded as a contributor to vaccine hesitancy, as it does not reflect anything significant about the person's perception about vaccines.

Lastly, the major cause of vaccine hesitancy was identified as “reluctance,” which in itself is a loosely defined term. Furthermore, the reasons leading to reluctance have not been mentioned in the article. An elaboration of the reasons for reluctance to vaccinate could enable programmers to do the needful to address this.

In conclusion, I commend the authors for their contribution toward a better understanding of vaccine hesitancy. I am confident that their efforts will take us closer toward the ultimate goal of universal vaccine coverage for a healthy, prosperous nation.

Acknowledgment

I gratefully acknowledge Dr. Joel Philip for his valuable feedback.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Dasgupta P, Bhattacherjee S, Mukherjee A, Dasgupta S. Vaccine hesitancy for childhood vaccinations in slum areas of Siliguri, India. Indian J Public Health 2018;62:253-8.
2Dubé E, Gagnon D, Zhou Z, Deceuninck G. Parental vaccine hesitancy in Quebec (Canada). PLoS Curr 2016;8. pii: ecurrents.outbreaks. 9e239605f4d320c6ad27ce2aea5aaad2.
3World Health Organization. The Guide to Tailoring Immunization Programmes. World Health Organization; 2013. Available from: http://www.euro.who.int/__data/assets/pdf_file/0003/187347/The-Guide-to-Tailoring-Immunization-Programmes-TIP.pdf?ua=1. [Last accessed on 2019 Feb 04].