Narrative shielding and pre-bunking: a synergistic strategy against vaccine hesitancy in pediatrics

INTRODUCTION: Vaccine hesitancy has emerged as a major challenge for pediatric immunization programs, shaped by a complex interplay of structural, relational, and informational factors. In Latin America, these dynamics are further influenced by health system fragmentation and social inequities, requiring approaches that extend beyond information-based interventions. AREAS COVERED: This review examines the multidimensional nature of vaccine hesitancy in pediatric populations, with a focus on Latin America. It examines the role of digital environments, clinical communication, and system-level factors, and discusses emerging strategies such as narrative communication and prebunking. The literature was identified through a targeted review of peer-reviewed publications and relevant global health reports. EXPERT OPINION: Addressing vaccine hesitancy requires integrated strategies that combine trust-building with anticipatory communication. Approaches such as narrative shielding and prebunking may complement traditional interventions by strengthening how caregivers interpret vaccine-related information. Future efforts should prioritize context-specific implementation and evaluation in real-world settings.