Understanding Vaccine Hesitancy [STAT Summit 2026 Review #22]

Report 22. Understanding Vaccine Hesitancy

Part I. English Version

1. Event / Date & Time

Event: Understanding Vaccine Hesitancy

Conference: STAT Summit 2026

Date & Time: October 15, 2026 | 10:05 AM EDT

2. Participants

Speakers

- Cory Anderson, Ph.D. — Assistant Professor of Public Health Sciences, Penn State College of Medicine

- Jennifer A. Reich, Ph.D. — Professor of Sociology, University of Colorado Denver

Moderator

- Nicholas Florko — Trust-in-Science Reporter, STAT

3. Summary

Community Context of Hesitancy: Vaccine decisions among Amish, Mennonite and other populations are shaped by differing social norms, community relationships and views of authority.

Limits of Aggregate Coverage: High national vaccination rates can conceal local clusters of under-immunization and related outbreak vulnerabilities.

Trust-Based Communication: Effective engagement requires listening to families’ concerns and explaining the collective value and uncertainties of vaccination without dismissing lived experience.

4. Main Discussion

Measles Outbreak and Diverse Communities

Moderator Florko cited more than 1,200 reported measles cases in a Pennsylvania outbreak affecting Amish and Mennonite communities. Anderson stressed that these communities are not uniform in their healthcare practices. He described an Amish population of roughly 400,000, high family size and strong retention within communities, arguing that culturally informed engagement is essential.

Anderson cautioned that Amish and related Plain communities differ in theology, social organization, patterns of healthcare use and willingness to vaccinate. He cited an Amish population near 400,000 and noted a large average family size and high retention across generations; his projection of substantially greater population size by 2075 was his own estimate, not an official census forecast. Religious beliefs, practical access barriers and the fact that some households have fewer routine touchpoints with hospitals or public schools can all affect vaccination opportunities. He therefore discouraged relying on a single explanation for lower vaccination rates. Approaches built with local community members and clinical personnel may be more viable than generic national messages.

Anderson cautioned that Amish and related Plain communities are not a uniform population. He described a rapidly growing population shaped by large families and strong community retention: an estimated fertility rate of 6.1 children per woman and a retention rate of roughly 85% were among his figures. He also projected substantial population growth over coming decades. These demographic estimates were attributed to his research and should not be generalized to every congregation. The public-health relevance is not the size of one outbreak alone but the way household relationships, religious and community organization, access to care and experiences with public institutions can create localized patterns of vaccination and transmission.

Individual Autonomy and Family Decision-Making

Reich described how vaccination hesitancy is not limited to geographically isolated religious communities. Among other families, strong expectations that parents must individually optimize their children’s health can conflict with vaccination’s collective benefits. Similar concerns can arise from different social backgrounds, so a single messaging strategy may be inadequate.

Reich drew attention to parents who are not committed anti-vaccine activists yet postpone, separate or selectively accept immunizations. She recalled research indicating that before COVID-19 roughly 20–30% of U.S. parents who were not ideologically opposed still modified vaccination timing. Decisions may be shaped by a perceived low probability of disease, anxiety about possible adverse reactions and the strong social expectation that a good parent must individually optimize every choice. Reich called this broader situation a structural problem of family support and decision burdens rather than simply a deficit of information. In her analysis, patients and parents are embedded in advice networks in which practical experiences with medicine influence later choices.

Reich argued against a simple divide between supposedly rational experts and uninformed parents. Vaccine decisions often involve competing understandings of parental responsibility, protection from risk and autonomy over children’s healthcare. A mother who questions a recommended schedule may be motivated by concern rather than indifference to her child’s health. Dismissing questions can intensify resistance and make later dialogue harder. At the same time, the panel did not treat all claims about vaccine safety as equally supported by scientific evidence. Its practical recommendation was to preserve the distinction between listening respectfully to people’s experiences and clearly communicating the strength, limits and public-health consequences of the evidence.

Local Clusters Behind National Averages

The speakers noted that roughly nine in ten U.S. parents fully vaccinate their children, but coverage is uneven across neighborhoods, schools and childcare settings. Socially connected groups can form clusters with low uptake, producing outbreak risks despite reassuring national averages. They cautioned against assuming all hesitancy has one cause.

National uptake estimates conceal important local patterns. Vaccination choices spread through neighborhoods, parenting groups, childcare networks and religious communities, which can create pockets of vulnerability even when the majority of families vaccinate. The panel distinguished these social dynamics from the simplistic claim that misinformation on social media alone explains the problem; Anderson observed that many Amish families have limited social-media engagement. Reich also noted that negative clinical experiences can circulate through trusted networks alongside otherwise ordinary parenting advice. More useful interventions include respectful engagement, convenient access, and clinicians who are willing to revisit a decision as family circumstances change. The panel did not suggest that all personal preferences can override infectious-disease protection for others.

The Pennsylvania measles outbreak, described by the moderator as exceeding 1,200 cases, served as a reminder that national vaccination averages can conceal pockets of susceptibility. The panel emphasized the need to understand local social networks and practical access conditions when designing outreach. Outreach by trusted clinicians or community members may differ from national media campaigns in credibility and reach. Discussions of COVID-19 also raised the challenge of uncertainty and changing recommendations: public agencies must explain what has changed in the evidence rather than simply announce a new directive. The session’s findings concerned social mechanisms and communication practice, not a controlled evaluation of one intervention.

Lessons from COVID-19 and Patient Engagement

The panel discussed how the public emphasis on the novel mRNA platform and the politicization of vaccine debates complicated communication. Reich advocated taking patients’ and parents’ lived experience seriously rather than relying solely on authoritative recommendations, while preserving attention to infectious-disease risks shared by communities.

The COVID-19 period was discussed as a lesson in scientific language and public ownership. Reich said publicity around the word “mRNA” made a platform unfamiliar to many people seem unusually experimental, while publicly funded research and manufacturing capacity were not always explained as shared investments. At vaccination clinics, ambiguous advice about selecting among brands could leave patients feeling that expertise was being replaced by personal guesswork. Anderson and Reich argued for humility in expert communication without abandoning evidence-based guidance. A productive approach would combine clarity about risk and benefit with awareness of culture, access, service environments and the autonomy that families exercise over time. Several examples remained the speakers’ interpretations rather than controlled intervention results.

A further thread concerned the pressure placed on caregivers—especially mothers—to make perfect risk decisions with incomplete information. The speakers recognized that demands for individual responsibility can become especially intense when children experience illness, even though structural factors such as access to preventive care and trustworthy sources are outside a family’s control. They urged communicators to acknowledge uncertainty without creating false equivalence between established scientific findings and unsupported assertions. This creates a broader R&D implication: evidence generation should be coupled with social research that tests how recommendations are understood by different populations and how equitable access shapes behavior.

5. Insights

Behavioral and Social Research: Vaccination programs benefit from understanding how community identity, social networks and individual risk perceptions shape uptake.

Implications for South Korea: Korea could combine national coverage data with local risk mapping and community-specific communication when planning immunization outreach.

Trusted Local Partnerships: Working with clinicians, families and community leaders may reduce polarization and improve response to vaccine-preventable outbreaks.

Report 22. Understanding Vaccine Hesitancy_eng.pdf

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