Predictors of Vaccine Hesitancy: Implications for COVID-19 Public Health Messaging

Int J Environ Res Public Health. 2021 Jul 29;18(15):8054. doi: 10.3390/ijerph18158054.


Objectives: Successful immunization programs require strategic communication to increase confidence among individuals who are vaccine-hesitant. This paper reviews research on determinants of vaccine hesitancy with the objective of informing public health responses to COVID-19.

Method: A literature review was conducted using a broad search strategy. Articles were included if they were published in English and relevant to the topic of demographic and individual factors associated with vaccine hesitancy.

Results and discussion: Demographic determinants of vaccine hesitancy that emerged in the literature review were age, income, educational attainment, health literacy, rurality, and parental status. Individual difference factors included mistrust in authority, disgust sensitivity, and risk aversion.

Conclusion: Meeting target immunization rates will require robust public health campaigns that speak to individuals who are vaccine-hesitant in their attitudes and behaviours. Based on the assortment of demographic and individual difference factors that contribute to vaccine hesitancy, public health communications must pursue a range of strategies to increase public confidence in available COVID-19 vaccines.

Keywords: COVID-19; individual differences; public health; vaccine hesitancy.

Publication types

  • Review

MeSH terms

  • COVID-19 Vaccines
  • COVID-19*
  • Health Communication*
  • Humans
  • Public Health
  • SARS-CoV-2
  • Vaccination
  • Vaccines*


  • COVID-19 Vaccines
  • Vaccines