A crisis of public confidence in vaccines.

A meeting was held in Siena, Italy, in July 2010 to review the evidence for a decrease in public confidence in vaccines, to discuss possible reasons for this phenomenon, and to develop possible strategies to improve public confidence in vaccines. Prevention of morbidity and mortality by vaccination is one of the major public health accomplishments of the last century. Nevertheless, despite the improved safety and effectiveness of vaccines, public confidence in vaccination is decreasing. Improved methods of vaccine safety assessment have not improved public confidence. In addition, dissemination of false information on the Internet has undermined public confidence globally. Reductions in vaccine uptake or use of available vaccines can and have resulted in increased morbidity and mortality due to infectious diseases. The lack of public confidence in vaccines risks undermining the political will necessary to rapidly respond to a more severe influenza pandemic in the future. To improve the current situation, we must define both the risks and the benefits of individual vaccines so that the public can understand the rationale for vaccine recommendations. Key to regaining public trust in vaccines is a credible, consistent, and unified message developed from the private and public sectors that directly addresses public concerns. Unless an active effort is made to improve public confidence and trust in vaccination, there is a risk that gains made in combating the morbidity and mortality of infectious diseases through the use of vaccines will be lost. Loss of political will resulting from this loss of public confidence may also result in inappropriate decisions regarding the development and use of pandemic influenza vaccines for use in future pandemics, thus compromising public health.