Anderson RM, Vegvari C, Truscott J, Collyer BJ. Challenges in creating herd immunity to SARS-CoV-2 infection by mass vaccination. Lancet. 2020; 396:(10263)1614-1616

Caserotti M, Girardi P, Rubaltelli E, Tasso A, Lotto L, Gavaruzzi T. Associations of COVID-19 risk perception with vaccine hesitancy over time for Italian residents. Soc Sci Med. 2021; 272

Fewer black and Filipino NHS staff vaccinated amid ‘hesitancy’ concern. 2021. (accessed 3 June 2021)

Dubé E. Addressing vaccine hesitancy: the crucial role of healthcare providers. Clin Microbiol Infect. 2017; 23:(5)279-280

European Centre for Disease Prevention and Control. Rapid literature review on motivating hesitant population groups in Europe to vaccinate. (accessed 3 June 2021)

Finney Rutten LJ, Zhu X, Leppin A Evidence-based strategies for clinical organizations to address COVID-19 vaccine hesitancy. Mayo Clin Proc. 2021; 96:(3)699-707

Freeman D, Loe BS, Chadwick A COVID-19 vaccine hesitancy in the UK: the Oxford coronavirus explanations, attitudes, and narratives survey (Oceans) II. Psychol Med. 2021; 1-15

Jarrett C, Wilson R, O'Leary M, Eckersberger E, Larson HJ Strategies for addressing vaccine hesitancy–a systematic review. Vaccine. 2015; 33:(34)4180-4190

Grant A, Hunter PR. Immunisation, asymptomatic infection, herd immunity and the new variants of COVID-19.: MedRxiv; 2021

Loiacono MM, Mahmud SM, Chit A Patient and practice level factors associated with seasonal influenza vaccine uptake among at-risk adults in England, 2011 to 2016: an age-stratified retrospective cohort study. Vaccine X. 2020; 4

NHS England. Guidance to support COVID-19 vaccine uptake in frontline staff: guidance for HR directors. 2021. (accessed 3 June 2021)

Public Health England. Making every contact count (MECC): consensus statement. 2016. (accessed 3 June 2021)

Public Health England. Disparities in the risk and outcomes of COVID-19. 2020. (accessed 3 June 2021)

Royal Society of Public Health. New poll finds BAME groups less likely to want COVID vaccine. 2020. (accessed 3 June 2021)

Ryan KA, Filipp SL, Gurka MJ, Zirulnik A, Thompson LA. Understanding influenza vaccine perspectives and hesitancy in university students to promote increased vaccine uptake. Heliyon. 2019; 5:(10)

Scientific Advisory Group for Emergencies. Factors influencing COVID-19 vaccine uptake among minority ethnic groups. 2020. (accessed 3 June 2021)

Sonawane K, Troisi CL, Deshmukh AA. COVID-19 vaccination in the UK: addressing vaccine hesitancy. Lancet Regional Health - Europe. 2021; 1

Thomson A, Robinson K, Vallée-Tourangeau G. The 5As: a practical taxonomy for the determinants of vaccine uptake. Vaccine. 2016; 34:(8)1018-1024

While AE. Are nurses fit for their public health role?. Int J Nurs Stud. 2014; 51:(9)1191-1194

World Health Organization. Strategies for addressing vaccine hesitancy-a systematic review. 2014. (accessed 3 June 2021)

World Health Organization. Barriers of influenza vaccination intention and behavior-a systematic review of influenza vaccine hesitancy 2005–2016. 2016. (accessed 3 June 2021)

World Health Organization. COVID-19 vaccines: safety surveillance manual. 2020. (accessed 3 June 2021)

Zhang J, While AE, Norman IJ. Seasonal influenza vaccination knowledge, risk perception, health beliefs and vaccination behaviours among nurses. Epidemiol Infect. 2012; 140:(9)1569-1577

Evidence-based strategies to promote vaccine acceptance

02 July 2021
Volume 26 · Issue 7


The success of a vaccination programme depends upon its coverage so that it provides herd immunity. Vaccine hesitancy has the potential to undermine a vaccine programme. Evidence suggests that some strategies are more effective in promoting vaccination uptake. Community nurses should help in the promotion of vaccination uptake using evidence-based interventions and through ‘Making Every Contact Count’.

Despite a substantial majority of the UK population holding positive views about the COVID-19 vaccine (Freeman et al, 2021), the success of the UK mass vaccination programme will depend on a high uptake across the whole population. Anderson et al (2020) have set out how the extent of vaccination coverage is calculated to yield herd immunity, with the efficacy of the vaccine and duration of the immune response complicating the calculation. Another complicating factor is the mutation (antigenic drift) of the virus, which may undermine existing vaccine efficacy. The percentage of the population that must be vaccinated initially is larger than in subsequent years once population immunity is stabilised. More recently, Grant and Hunter (2021) have questioned whether it will be possible to achieve an adequate level of population COVID-19 immunity using vaccination alone, because not all the vaccines prevent asymptomatic infections. Although less infectious, these asymptomatic infections will still enable population transmission. In summary, the ability of the vaccination programme for COVID-19 to manage the disease, like other vaccination programmes for seasonal influenza, measles, polio. etc., will depend on the extent of uptake by the population, and, in the case of the COVID-19 vaccination, an uptake of at least 80%, if not higher, will be required during the first year of the vaccination roll-out (Anderson et al, 2020).

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