Date of Award

Spring 2020

Degree Type



Epidemiology and Biostatistics

Director of Thesis

Dr. Edena Guimaraes

Second Reader

Dr. Myriam Torres


Vaccines are one of the world’s most impactful medical therapies. They are cost-effective, successfully proven, and one of the quickest treatment options available today (Clark et al., 2016). They save millions of lives every year and have eliminated certain diseases on a national and international level. However, millions of people worldwide still remain unvaccinated. In developed nations, mainly The United States (U.S.) and the European countries, many of the unvaccinated are a result of rising vaccine hesitancy of parents in conjunction with the anti-vaccination movement. Vaccine hesitancy is defined as “a delay in acceptance or refusal of vaccines despite availability” (Macdonald, 2015, p. 34). After a thorough literature review, evidence reveals that there is a gap between perceived vaccine importance and perceived vaccine safety in developed nations as many survey respondents believe in the efficacy and importance of vaccines but lack confidence in the safety of vaccines. This gap is seemingly connected to overall health literacy. The Patient Protection and Affordable Care Act of 2010, Article V, defines health literacy as a patient’s ability to “obtain, communicate, and process” health services and information needed to make health decisions (Department of Health and Human Services [HHS], 2010). However, more direct and detailed projects must be conducted before a direct connection can be made.

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