Table 2. World Health Organization’s Vaccine Hesitancy Determinants Matrix (reproduced from MacDonald 2015, 4163).

Contextual influences   Influences arising due to historic, socio-cultural, environmental, health system/institutional, economic or political factors	(a) Communication and media environment (b) Influential leaders, immunisation programme gatekeepers and anti- or pro-vaccination lobbies (c) Historical influences (d) Religion/culture/gender/socio-economic (e) Politics/policies (f) Geographic barriers (g) Perception of the pharmaceutical industry
Individual and group influences   Influences arising from personal perception of the vaccine or influences of the social/peer environment	(a) Personal, family and/or community members’ experience with vaccination, including pain (b) Beliefs, attitudes about health and prevention (c) Knowledge/awareness (d) Health system and providers – trust and personal experience (e) Risk/benefit (perceived, heuristic) (f) Immunisation as a social norm vs. not needed/harmful
Vaccine/vaccination – specific issues Directly related to vaccine or vaccination	(a) Risk/benefit (epidemiological and scientific evidence) (b) Introduction of a new vaccine or new formulation or a new recommendation for an existing vaccine (c) Mode of administration (d) Design of vaccination programme/Mode of delivery (e.g. routine programme or mass vaccination campaign) (e) Reliability and/or source of supply of vaccine and/or vaccination equipment (f) Vaccination schedule (g) Costs (h) The strength of the recommendation and/or knowledge base and/or attitude of healthcare professionals