Multi-level factors driving vaccine hesitancy and vaccine uptake: individual, structural, systemic, and technological
“Vaccine uptake” is defined as the completion of a vaccination series per administration schedule as recommended by medical experts and appropriate institutions. Vaccine uptake is complex and driven by individual-level factors, structural and systemic factors, and technological factors; these impacts are amplified for underserved communities. Although vaccine uptake has increased, underserved communities have been historically overlooked by public health strategies tailored to resource-rich communities with predominantly English-speaking residents [At the individual level, the research and popular literature have increasingly focused on the concept of “vaccine hesitancy.” Vaccine hesitancy refers to delay in acceptance or refusal of vaccination despite availability of vaccination services [The pandemic has created an overall reduction in timeliness of immunizations and preventive service completion [Systemic and logistical factors also impact access to the COVID-19 vaccine. The digital divide (i.e., differential access to technology needed to schedule appointments and obtain updated health information) precludes a sizeable portion of the population from accessing web-based scheduling portals to set up vaccination appointments. Individuals also need to access information in their preferred languages to make informed decisions about vaccination and to schedule vaccination appointments. Compounding these structural factors, concerns about the need to take sick or unpaid leave, or secure childcare, due to vaccine side effects might negatively impact vaccine uptake.