Meeting the unvaccinated and undervaccinated where they are reveals how response efforts have overfocused on an inadequate “vaccine hesitancy” framework that places the onus of motivation and of accessing the vaccine on the individual. Instead, we need to broaden our understanding and invest significantly in vaccine demand, a concept – explained in more depth in chapter 2 – that inherently acknowledges and addresses institutional and structural failures and responsibilities alongside individual-level drivers of vaccination.
The struggle to generate vaccine demand is not unique to the U.S., and is increasingly challenging vaccine efforts around the world as countries try to reach beyond those who were eager to be vaccinated. In February 2022, John Nkengasong, Director of the Africa Centres for Disease Control and Prevention, ordered vaccine donations for the continent paused because challenges with logistics and vaccine confidence are preventing people from accessing Covid-19 vaccines before they expire. At the same time, political will to invest in global vaccination is in decline.
In a world with dramatically increased capacities to develop, manufacture and distribute vaccines, pandemic resilience will increasingly depend on the ability of governments, experts, institutions and community leaders to equitably build and maintain demand in those vaccines.
Working to improve health equity, meet the massive information needs of diverse communities, and build trust in the process are required for people to embrace vaccines and other public health measures as the life-saving tools they can be.
In this report, we provide an evidence-based roadmap through key frameworks and promising practices that practitioners and policy makers should consider when assessing and planning their vaccine demand strategies.