Estratégias comunicacionais em hesitação vacinal infantil: revisão de escopo
DOI:
https://doi.org/10.11606/s1518-8787.2026060007242Palabras clave:
Vacinação, Hesitação Vacinal, Comunicação em Saúde, Revisão de EscopoResumen
OBJETIVO: Analisar como as configurações comunicativas são abordadas nos estudos empíricos sobre a hesitação vacinal infantil, com ênfase nas estratégias e meios comunicacionais utilizados, bem como nas formas pelas quais esses elementos influenciam as decisões de pais e cuidadores. MÉTODOS: Revisão de escopo, conduzida em cinco bases de dados (Scopus, Web of Science, PubMed, SciELO e Lilacs), sobre hesitação vacinal infantil e estratégias comunicacionais, com artigos publicados entre 2015 e 2017, nos idiomas inglês, português, espanhol e francês. Foram incluídos estudos empíricos sobre vacinação infantil, com a idade das crianças determinada pelo próprio autor do estudo. Para a análise das informações extraídas por cinco pesquisadores de forma independente, foi realizada síntese temática, com base em uma matriz de codificação, que categorizou os achados em temas centrais. A análise foi orientada teoricamente com base no conceito de configurações comunicativas de Hepp e Hasebrink. RESULTADOS: Foram analisados 22 estudos, os quais foram majoritariamente realizados nos Estados Unidos (n = 9), envolvendo principalmente pais/cuidadores e profissionais de saúde. As redes sociais destacaram-se como mídia central, com papel ambivalente: como meio de desinformação, mas também de mensagens pró-vacina. Estratégias com mensagens científicas claras, a ferramenta Motive e a análise de discursos antivacina mostraram-se promissoras para aumentar a intenção de vacinar. Relações de confiança entre médicos e famílias e a personalização das mensagens foram identificadas como fundamentais. CONCLUSÃO: A comunicação em saúde é fundamental no enfrentamento da hesitação vacinal infantil. Os estudos avaliados indicam que estratégias integradas, combinando políticas públicas baseadas em evidências com comunicação personalizada e culturalmente sensível são essenciais para promover adesão à vacinação e maior confiança nas vacinas.
Referencias
1. Rémy V, Zöllner Y, Heckmann U. Vaccination: the cornerstone of an efficient healthcare system. J Mark Access Health Policy. 2015;3(1):27041. https://doi.org/10.3402/jmahp.v3.27041
2. Ministério da Saúde (BR). Manual de normas e procedimentos para vacinação. Brasília: Ministério da Saúde; 2014 [citado 2026 mar 31]. Disponível em: https://bvsms.saude.gov.br/bvs/ publicacoes/manual_procedimentos_vacinacao.pdf
3. Brasil. Lei Nº 8.069, de 13 de julho de 1990. Estatuto da criança e do adolescente. Diário Oficial da União. 16 jul 1990 [citado 2026 mar 31]. Disponível em: http://www.planalto.gov.br/ ccivil_03/leis/l8069.htm
4. Schuster M, Eskola J, Duclos P. Review of vaccine hesitancy: rationale, remit and methods. Vaccine. 2015;33(34):4157-60. https://doi.org/10.1016/j.vaccine.2015.04.035
5. Bedford H, Attwell K, Danchin M, Marshall H, Corben P, Leask J. Vaccine hesitancy, refusal and access barriers: the need for clarity in terminology. Vaccine. 2018;36(44):6556-8. https://doi.org/10.1016/j.vaccine.2017.08.004
6. World Health Organization – WHO. Behavioural and social drivers of vaccination: tools and practical guidance for achieving high uptake. Geneva: World Health Organization; 2022 [citado 2026 mar 31]. Disponível em: https://iris.who.int/handle/10665/354459
7. Brown AL, Sperandio M, Turssi CP, Leite RMA, Berton VF, Succi RM et al. Vaccine confidence and hesitancy in Brazil. Cad Saude Publica. 2018;34(9):e00011618. https://doi.org/10.1590/0102-311x00011618
8. Matos CCDS, Couto MT, Oduwole EO, Wiysonge CS. Caregivers’ perceptions on routine childhood vaccination: a qualitative study on vaccine hesitancy in a South Brazil state capital. Hum Vaccin Immunother. 2024;20(1):2298562. https://doi.org/10.1080/21645515.2023.2298562
9. Barbieri CLA, Couto MT. Decision-making on childhood vaccination by highly educated parents. Rev Saúde Publica. 2015;49:18. https://doi.org/10.1590/S0034-8910.2015049005149
10. Brunson EK. How parents make decisions about their children’s vaccinations. Vaccine. 2013;31(46):5466-70. https://doi.org/10.1016/j.vaccine.2013.08.104
11. Matos CCDS, Gonçalves BA, Couto MT. Vaccine hesitancy in the global south: Towards a critical perspective on global health. Glob Public Health. 2022;17(6):1087-98. https://doi.org/10.1080/17441692.2021.1912138
12. Arif N, Al-Jefri M, Bizzi IH, Perano GB, Goldman M, Haq I et al. Fake News or weak science? Visibility and characterization of antivaccine webpages returned by google in different languages and countries. Front Immunol. 2018;9:1215. https://doi.org/10.3389/fimmu.2018.01215
13. Matos CCDS, Barbieri CLA, Couto MT. Covid-19 and its impact on immunization programs: reflections from Brazil. Rev. Saude Publica. 2020;54:114. https://doi.org/10.11606/s1518-8787.2020054003042
14. Ghaznavi C, Eguchi A, Lwin KS, Yoneoka D, Tanoue Y, Rauniyar SK et al. Estimating global changes in routine childhood vaccination coverage during the COVID-19 pandemic, 2020–2021. Vaccine. 2023;41(28):4151-7. https://doi.org/10.1016/j.vaccine.2023.05.034
15. Goldstein S, MacDonald NE, Guirguis S. Health communication and vaccine hesitancy. Vaccine. 2015;33(34):4212-4. https://doi.org/10.1016/j.vaccine.2015.04.042
16. Leask J, Kinnersley P, Jackson C, Cheater F, Bedford H, Rowles G. Communicating with parents about vaccination: a framework for health professionals. BMC Pediatr. 2012;12:154. https://doi.org/10.1186/1471-2431-12-154
17. Avelino-Silva VI, Ferreira-Silva SN, Soares MEM, Vasconcelos R, Fujita L, Medeiros T et al. Say it right: measuring the impact of different communication strategies on the decision to get vaccinated. BMC Public Health. 2023;23(1):1162. https://doi.org/10.1186/s12889-023-16047-2
18. Peters MD, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil H. Scoping reviews. In: Aromataris E, Lockwood C, Porritt K, Pilla B, Jordan Z, editors. JBI Manual for Evidence Synthesis. Adelaide: JBI; 2024 [citado 2026 mar 31]. Disponível em: https://jbi-global-wiki.refined.site/space/MANUAL/355862497/10.+Scoping+reviews
19. Hepp A. The communicative figurations of mediatized worlds: mediatization research in times of the “mediation of everything”. Matrizes. 2014;8(1):45-64. https://doi.org/10.11606/issn.1982-8160.v8i1p45-64
20. Hepp A, Hasebrink U. Interação humana e configurações comunicativas: transformações culturais e sociedades midiatizadas. Parágrafo. 2015;3(2):75-90. Disponível em: https://revistaseletronicas.fiamfaam.br/index.php/recicofi/article/view/333
21. Barton SM, Calhoun AW, Bohnert CA, Multerer SM, Statler VA, Bryant KA et al. Standardized vaccine-hesitant patients in the assessment of the effectiveness of vaccine communication training. J Pediatr. 2022;241:203-211.e1. https://doi.org/10.1016/j.jpeds.2021.10.033
22. Cole JW, Chen AMH, McGuire K, Berman S, Gardner J, Teegala Y. Motivational interviewing and vaccine acceptance in children: The MOTIVE study. Vaccine. 2022;40(12):1846-54. https://doi.org/10.1016/j.vaccine.2022.01.058
23. Glanternik JR, McDonald JC, Yee AH, Howell Ba A, Saba KN, Mellor RG et al. Evaluation of a Vaccine-communication tool for physicians. J Pediatr. 2020;224:72-78.e1. https://doi.org/10.1016/j.jpeds.2020.06.007
24. Nagar R, Venkat P, Stone LD, Engel KA, Sadda P, Shahnawaz M. A cluster randomized trial to determine the effectiveness of a novel, digital pendant and voice reminder platform on increasing infant immunization adherence in rural Udaipur, India. Vaccine. 2018;36(44):6567-77. https://doi.org/10.1016/j.vaccine.2017.11.023
25. Pluviano S, Watt C, Ragazzini G, Della Sala S. Parents’ beliefs in misinformation about vaccines are strengthened by pro-vaccine campaigns. Cogn Process. 2019;20(3):325-31. https://doi.org/10.1007/s10339-019-00919-w
26. Steffens MS, Dunn AG, Marques MD, Danchin M, Witteman HO, Leask J. Addressing myths and vaccine hesitancy: a randomized trial. Pediatrics. 2021;148(5):e2020049304. https://doi.org/10.1542/peds.2020-049304
27. Doliński D, Kulesza W, Rędzio AM, Muniak P, Guzek M, Silczuk A et al. The Effects of offering freedom to comply by pediatricians and nurses, using the but-you-are-free (BYAF) technique, on vaccination compliance on 185 parents of newborn babies conducted in outpatient clinics in poland between January 2022 and July 2022. Med Sci Monit. 2022;29:e938743. https://doi.org/10.12659/MSM.938743
28. Berry NJ, Henry A, Danchin M, Trevena LJ, Willaby HW, Leask J. When parents won’t vaccinate their children: a qualitative investigation of australian primary care providers’ experiences. BMC Pediatr. 2017;17(1):19. https://doi.org/10.1186/s12887-017-0783-2.
29. Berry NJ, Danchin M, Trevena L, Witteman HO, Kinnersley P, Snelling T et al. Sharing knowledge about immunisation (SKAI): an exploration of parents’ communication needs to inform development of a clinical communication support intervention. Vaccine. 2018;36(44):6480-90. https://doi.org/10.1016/j.vaccine.2017.10.077
30. Duchsherer A, Jason M, Platt CA, Majdik ZP. Immunized against science: Narrative community building among vaccine refusing/hesitant parents. Public Underst Sci. 2020 May;29(4):419-35. https://doi.org/10.1177/0963662520921537
31. Hughes B, Miller-Idriss C, Piltch-Loeb R, Goldberg B, White K, Criezis M et al. Development of a codebook of online anti-vaccination rhetoric to manage COVID-19 vaccine misinformation. Int J Environ Res Public Health. 2021;18(14):7556. https://doi.org/10.3390/ijerph18147556
32. Lockhart S, Dempsey AF, Pyrzanowski J, O’Leary ST, Barnard JG. Provider and parent perspectives on enhanced communication tools for human papillomavirus vaccine–hesitant parents. Acad Pediatr. 2018;18(7):776-82. https://doi.org/10.1016/j.acap.2018.05.012
33. Özen F, Aydın A, Ekerbiçer H, Etçioğlu E, Aydın M, Köse E et al. Evaluation of antivaccination movement in Turkey: qualitative reports of family physicians. East Mediterr Health J. 2022;28(3):183-9. https://doi.org/10.26719/emhj.22.002
34. Randall S, Leask J, Robinson P, Danchin M, Kinnersley P, Witteman H et al. Underpinning of the sharing knowledge about immunisation (SKAI) communication approach: a qualitative study using recorded observations. Patient Educ Couns. 2020;103(6):1118-24. https://doi.org/10.1016/j.pec.2019.12.014
35. Shay LA, Baldwin AS, Betts AC, Marks EG, Higashi RT, Street RL et al. Parent-provider communication of hpv vaccine hesitancy. Pediatrics. 2018;141(6):e20172312. https://doi.org/10.1542/peds.2017-2312.
36. Akram DS, Taj S, Siddiqui MB. Effect of electronic and social media messages on typhoid conjugate vaccination campaign. Pak Pediatr J. 2021;45(2):233-8.
37. Brunelli L, Valent F, Romanese F, Tricarico P, Pellizzaro A, d’Angelo M et al. Parental trust and beliefs after the discovery of a six-year-long failure to vaccinate. Hum Vaccin Immunother. 2021;17(2):583-7. https://doi.org/10.1080/21645515.2020.1777820
38. Hopfer S, Wright ME, Pellman H, Wasserman R, Fiks AG. HPV vaccine recommendation profiles among a national network of pediatric practitioners: understanding contributors to parental vaccine hesitancy and acceptance. Hum Vaccin Immunother. 2019;15(7-8):1776-83. https://doi.org/10.1080/21645515.2018.1560771.
39. Kim SJ, Schiffelbein JE, Imset I, Olson AL. Countering antivax misinformation via social media: message-testing randomized experiment for human papillomavirus vaccination uptake. J Med Internet Res. 2022;24(11):e37559. https://doi.org/10.2196/37559
40. Llavona-Ortiz JY, Spanos KE, Kraschnewski JL, D’Souza G, Myrick JG, Sznajder KK et al. Associations between human papillomavirus vaccine decisions and exposure to vaccine information in social media. Cancer Control. 2022;29:10732748221138404. https://doi.org/10.1177/10732748221138404
41. Panozzo CA, Head KJ, Kornides ML, Feemster KA, Zimet GD. Tailored Messages addressing human papillomavirus vaccination concerns improves behavioral intent among mothers: a randomized controlled trial. J Adolesc Health. 2020;67(2):253-61. https://doi.org/10.1016/j.jadohealth.2020.01.024
42. Seytre B, Chaibou S, Simon B. The drivers of low vaccination utilization in niger. Am J Trop Med Hyg. 2024;110(3):529-33. https://doi.org/10.4269/ajtmh.23-0708
43. Klintman M. Apollonian and Dionysian trust in vaccination. In: Borin L, Hammarlin MM, Kokkinakis D, Miegel F, editors. Vaccine hesitancy in the nordic countries: trust and distrust during the COVID-19 Pandemic [Internet]. London: Routledge; 2024 [citado 2026 mar 31]. p. 21-4. Disponível em: https://library.oapen.org/bitstream/ handle/20.500.12657/89506/9781040011614.pdf
44. Bussink-Voorend D, Hautvast JLA, Vandeberg L, Visser O, Hulscher MEJL. A systematic literature review to clarify the concept of vaccine hesitancy. Nat Hum Behav. 2022;6(12):1634-48. https://doi.org/10.1038/s41562-022-01431-6
45. Larson HJ. Defining and measuring vaccine hesitancy. Nat Hum Behav. 2022;6(12):1609-10. https://doi.org/10.1038/s41562-022-01484-7. 46. Couto MT. Vacinação. In: Szwako J, Ratton JL, organizadores. Dicionário dos negacionismos no Brasil. Recife: Cepe; 2022. p. 301-8.
47. Sobo EJ. Theorizing (vaccine) refusal: through the looking glass. Cult Anthropol. 2016;31(3):342-50. https://doi.org/10.14506/ca31.3.04
48. McGranahan C. Theorizing refusal: an introduction. Cult Anthropol. 2016;31(3):319-25. https://doi.org/10.14506/ca31.3.01
49. Hjarvard S. Mediatization: conceptualizing cultural and social change. Matrizes. 2014;8(1):21-44. https://doi.org/10.11606/issn.1982-8160.v8i1p21-44
50. Roy DN, Biswas M, Islam E, Azam MS. Potential factors influencing COVID-19 vaccine acceptance and hesitancy: a systematic review. PLoS One. 2022;17(3):e0265496. https://doi.org/10.1371/journal.pone.0265496
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Derechos de autor 2026 Elisangela Rodolfo Miras, Cristiane Spadacio, Bruna Aparecida Gonçalves, Elda de Oliveira, Paulo Henrique Nico Monteiro, Luan Nascimento Lázaro, Pamela Machado Polato, Júlia Zaparolli, Lorruan Alves dos Santos, Camila Carvalho de Souza Amorim Matos, Carolina Luisa Alves Barbieri, Marcia Thereza Couto

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Fundação de Amparo à Pesquisa do Estado de São Paulo
Números de la subvención 2023/17912-4 -
Conselho Nacional de Desenvolvimento Científico e Tecnológico
Números de la subvención 420574/2023-9