Acceptability to stakeholders
The acceptability of child combination vaccination including DTP, HepB, Hib and polio vaccination, varies globally and is influenced by factors such as cultural beliefs, misinformation, relationships between parents and healthcare professionals, and perceived disease risk.Go to footnote 1, Go to footnote 2, Go to footnote 3, Go to footnote 4, Go to footnote 5
Evidence from Malaysia suggests that acceptability of introducing a fully liquid hexa-aP vaccine is also influenced by perceptions of vaccine safety, reduced number of injections, convenience, and confidence in the immunization programme.Go to footnote 3
DTP vaccine acceptance was high among parents in France (85%) and India (98%).Go to footnote 4
Pertussis vaccine acceptance in countries such as the United Kingdom, Italy, Ireland, Australia, West Germany and Russia has been influenced by adverse events and to lesser extent the low effectiveness of selected wP vaccines.Go to footnote 5
In polio endemic regions, vaccine resistance has been linked to misconceptions about vaccine safety and cultural opposition, despite awareness of the disease's severity. Conversely, in polio-free countries, vaccine acceptability is generally high, though complacency has led to gaps in coverage, as evidenced by recent vaccine-derived poliovirus (cVDPV) outbreaks in the United Kingdom and Israel. Addressing these challenges, global initiatives led by WHO, UNICEF, and the Global Polio Eradication Initiative (GPEI) have prioritized public education and community engagement to sustain vaccination acceptance and achieve eradication goals.Go to footnote 1, Go to footnote 2
- Go back to footnote reference 1
Global Polio Eradication Initiative (GPEI) (no date). Polio Today: Endemic Countries. (https://polioeradication.org/about-polio/polio-infected-countries/ accessed 28 August 2026).
- Go back to footnote reference 2
Global Polio Eradication Initiative (no date). Circulating vaccine-derived poliovirus count [website]. Geneva: Global Polio Eradication Initiative. Available at: (https://polioeradication.org/circulating-vaccine-derived-poliovirus-count/ , accessed 24 August 2026).
- Go back to footnote reference 3
Al Bashar, L., Dube, E., Kandasamy, T., Zaini, N., Abdul Rahman, H., et al. (2023) ‘Parents’ and healthcare professionals’ perception toward the introduction of a new fully liquid hexavalent vaccine in the Malaysian national immunization program: a cross-sectional study instrument development and its application’, Frontiers in Immunology, 14. doi:10.3389/fimmu.2023.1052450.
- Go back to footnote reference 4
Bakhache, P., Yewale, V., Parikh, R., Clancey, G., Spickernell, G., Berlaimont, V. & Turriani, E. (2022). Diphtheria-tetanus-pertussis (DTP) vaccination: understanding the perspectives and expectations of parents and healthcare professionals in France and India. Human Vaccines & Immunotherapeutics, 18(1), 1961468. doi:10.1080/21645515.2021.1961468.
- Go back to footnote reference 5
Gangarosa EJ, Galazka AM, Wolfe CR, Phillips LM, Miller E, Chen RT et al. Impact of anti-vaccine movements on pertussis control: the untold story. The Lancet 1998;351:356–361.