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. 2021 Sep 24;9:134929–134944. doi: 10.1109/ACCESS.2021.3115554

TABLE 2. Factors Creating the 6As With Their Definitions.

Root cause Definition with examples
Access The ability of individuals to be reached by, or to reach, recommended vaccines (e.g. location or convenience of access, etc.).
Affordability The ability of individuals to afford vaccination, both in terms of financial and non-financial costs (e.g. time, etc.).
Awareness The degree to which individuals know the need for, and availability of, recommended vaccines and their objective benefits and risks (e.g. availability of detailed information about vaccines and vaccination schedules, etc.).
Acceptance The degree to which individuals accept, contest or refuse vaccination (e.g. severity of disease, safety and efficacy of a vaccine, social responsibility, etc.).
Activation The degree to which individuals are nudged towards vaccine uptake (e.g. advertising, calling or sending an SMS, etc.).
Assurance The degree to which individuals have trust and certainty with regard to being protected, supported and cared for associated with the vaccination (e.g. preliminary medical tests before vaccination, post-vaccination medical support, insurance, etc.).