Vaccine Refusal as a Regional Problem

Vaccination is a critical public health practice carried out in all countries and saving two to three million lives annually. However, according to the World Health Organization, a significant increase in vaccine refusal rates is becoming a global problem. Adherence to active immunization varies significantly between countries and study periods. Previous surveys conducted in the Russian Federation did not allow assessment of the situation with vaccine hesitancy and refusal in the country as a whole or identification of regional specifics. Objective: To assess the proportion of vaccine refusals among all reasons for non-vaccination in the population of the Russian Federation. Materials and methods: We conducted a retrospective continuous cross-sectional study using data on the number of people who did not get vaccinated within the framework of the National Vaccination Schedule (NVS) due to vaccine refusal as of August–September 2022; information was obtained from all regions of the Russian Federation at the request of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor). Results: We established the regions where refusal to vaccinate was almost the only reason for non-vaccination of children and adults. At the same time, in about 20–25 % of the regions, the proportion of children not vaccinated in accordance with the NVS due to parental refusal of childhood vaccines was less than 60 %. In 35–40 % of the Russian regions, vaccine refusal in adults accounted for less than 50 % of all causes for non-vaccination. Most parents refused to vaccinate children against hepatitis B, as well as against pneumococcal infection, diphtheria, pertussis, and tetanus. Conclusions: The reasons for non-vaccination are region-specific. A systematic analysis of the causes for vaccine refusal is necessary at the level of each health facility and regional health authorities in order to reveal the main obstacle to vaccination and plan targeted measures to reduce its impact on the quality of active immunization.