Are we having the wrong conversation about vaccine hesitancy? Leading research projects weigh in with recommendations

Last night, the RIVER-EU project and JITSUVAX project, funded by the Horizon2020 research programme, joined forces at the European Health Forum Gastein to discuss the challenge of vaccine hesitancy. Co-hosted by EuroHealthNet, the session explored how vaccine hesitancy is often only a ‘proxy indicator’, not a primary cause, of unequal vaccination coverage. Panellists noted that placing the burden of change on the individual refusing or delaying vaccination is ignoring the important systemic failures which may influence their decision-making. These include political and social inequalities and health system barriers, faced primarily by underserved communities, and which often have an important impact on their beliefs and attitudes. The two projects presented findings from their work, including promising interventions to reduce inequalities in vaccine uptake and new tools to understand the roots of anti-vaccination arguments.

“Vaccine hesitancy is not solely an individual’s problem. It is usually not that parents don’t want their child to be vaccinated, but many parents hesitate because the health system is not sufficiently accessible. In RIVER-EU, we aim to address health system barriers faced by underserved populations in order to make health systems more responsive and equitable, with the expectation that this will reduce hesitation and increase vaccine uptake,” stated Prof Danielle Jansen, coordinator of the RIVER-EU project and Associate Professor at the University Medical Center Groningen (UMCG).

Prof Stephan Lewandowsky, coordinator of the JITSUVAX project and Professor at the University of Bristol, stated: “Vaccine hesitancy can arise from people’s deeply-held attitudes that are exploited by disinformers to create confusion about the safety and efficacy of vaccines. We develop conversational techniques that recognize and endorse people’s underlying attitudes, thereby providing the opportunity to engage in a productive conversation to dispel misperceptions.”

Representatives from the WHO Regional Office for Europe and the South-Eastern European Health Network (SEEHN) also provided their insights, focused particularly on how to build and maintain trust in the health system and ensure that no one is left behind.

Specific recommendations included:

  • Taking a comprehensive approach towards low vaccine uptake, understanding both the physical and psychological barriers that people may face regarding vaccination and acting to reduce these barriers, as necessary, through supportive legislation and increased human and financial resources for vaccination programmes.
  • More comprehensive training on vaccine communication, so that health professionals can identify and understand the dispositions, both psychological and socio-cultural, that lead people to refuse or delay vaccination.
  • Tailor communication, both to vulnerable populations (e.g., through translation and attention to health literacy levels), as well as to individuals in all populations (e.g., through empathetic counterarguments and personalised dialogues that specifically address individuals’ psychological and socio-cultural dispositions).
Watch the recording here


Funded by the Horizon 2020 Research Programme, RIVER-EU (“Reducing Inequalities in Vaccine Uptake in the European Region – Engaging Underserved Communities”) is a 5-year (2021-2026) project coordinated by the University Medical Center Groningen (UMCG). RIVER-EU collects evidence on health system determinants of high and low vaccine uptake in eight specific contexts, which will be used to identify and/or develop interventions to reduce barriers to vaccine uptake in underserved communities and increase trust in the health system.


JITSUVAX is working to develop refutational-based techniques that enhance healthcare professionals’ ability to counter misinformation about vaccines and help people make informed choices, thus enhancing vaccination uptake. The University of Bristol coordinates this project which is funded by the EU Horizon 2020 programme for four years (2021-2025). A core part of our work has been the development of a ‘taxonomy’ of fallacious beliefs about vaccination which identifies the psychological attitude roots behind these beliefs. We are currently field testing our new methodologies with healthcare professionals in several different contexts.

For further information, please contact:

Alison Maassen
Programme Manager

Ginny Gould
Research Project Manager

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