LAUSR

Vaccine hesitancy - the delay or refusal of vaccines despite their availability - has been linked to lower vaccination rates and outbreaks of vaccine-preventable diseases. Using cross-sectional surveys of 78,725 parents and other family members in the US, Nguyen et al. (Am J Epidemiol. 2022;XXX(XX):XXXX-XXXX) calculated the population attributable fraction (PAF) of vaccine hesitancy on non-receipt of recommended childhood vaccines, including influenza vaccine. The PAF is readily calculatable - p(rr-1)/rr, where p is the proportion of those hesitant among non-vaccinated individuals and rr is the risk ratio of non-vaccination between those hesitant over those non-hesitant. By vaccine, the PAF ranged from 6.5% for non-receipt of the hepatitis B vaccine birth dose to 31.3% for non-receipt of the diphtheria-tetanus-pertussis vaccine dose 3. For non-receipt of influenza vaccine, the PAF varied geographically, with relatively high values in some Northeast (e.g., New York at 22.6%) and Northwest (e.g., Oregon at 23.0%) states and lower values in certain Southern (e.g., Louisiana at 7.5%) and Mountain West (e.g., Utah at 8.8%) states. The PAF can elucidate the contribution of vaccine hesitancy on non-vaccination in different circumstances. Future studies can apply this technique in different populations and incorporate different measures of vaccine hesitancy.