a Cochrane South Africa , South African Medical Research Council , Cape Town , South Africa.
b School of Public Health and Family Medicine , University of Cape Town , Cape Town , South Africa.
Expert Rev Vaccines. 2018 Dec;17(12):1063-1070. doi: 10.1080/14760584.2018.1549994. Epub 2018 Nov 30.
Vaccine hesitancy, a growing global problem which is aggravated by vaccine related rumors and (mis)information, has the potential to reverse the gains from vaccination. Areas covered: We describe a selection of vaccine-related events that have made headlines and highlight the effects that these have had on vaccine acceptance. Drawing on these cases, and an adaptation of an epidemiological modeling of the spread of ideas, we propose that vaccine hesitancy can be grouped into two categories: 'baseline' and 'reactive' vaccine hesitancy. 'Baseline' vaccine hesitancy refers to the level of refusal or delay in acceptance of vaccinations that is constantly present in the population. Though it may vary, changes are unlikely to be sudden or dramatic. 'Reactive' hesitancy, which often occurs because of vaccine-related events, is characterized by a rapid spike in levels of hesitancy, usually subsiding at a slow rate. Expert commentary: Different kinds of interventions are needed to address different forms of vaccine hesitancy. Modeling the diffusion of (mis)information during vaccine hesitancy 'outbreaks' is essential for designing interventions that will ensure appropriate management of 'reactive' hesitancy, and control of 'baseline' levels of vaccine hesitancy. More empirical research is needed to test and better understand this hypothesis.
疫苗犹豫是一个日益严重的全球性问题，疫苗相关谣言和（错误）信息加剧了这一问题，有可能使疫苗接种取得的成果付诸东流。
我们描述了一些引起轩然大波的疫苗相关事件，并强调了这些事件对疫苗接种接受率的影响。借鉴这些案例，并对疫苗相关思想传播的流行病学模型进行改编，我们提出疫苗犹豫可分为两类：“基线”和“反应性”疫苗犹豫。“基线”疫苗犹豫是指人群中始终存在的拒绝或延迟接种疫苗的程度。尽管它可能会有所变化，但不太可能突然或剧烈变化。“反应性”犹豫通常是由于疫苗相关事件引起的，其特点是犹豫程度迅速上升，通常以较慢的速度下降。
需要采取不同的干预措施来解决不同形式的疫苗犹豫。在疫苗犹豫“爆发”期间对（错误）信息的传播进行建模对于设计干预措施至关重要，这些干预措施将确保对“反应性”犹豫进行适当管理，并控制“基线”疫苗犹豫水平。需要进行更多的实证研究来检验和更好地理解这一假设。
