phenomenon · claim-type · cross-domain-transfer · mechanism · claim-relation · replication-status · limitation — grounded in the full text| phenomenon | hesitancy as a SUB-GROUP property rather than a population-wide one, so that the measurement has to answer WHO, WHAT and WHERE separately— “Given that vaccine hesitancy is specific to sub-groups within populations and is rarely population-wide, it is important to first understand who is hesitant about vaccination, what their concerns are – i.e. which of the various possible reasons outlined above are driving their hesitancy, and where the hesitant individuals are located, i.e. in… | |
| claim-type | method— “The Working Group developed a compendium of three different types of survey questions (See Appendices): Core Closed Questions (Appendix A); Likert Scale Questions (Appendix B); and a set of Open Ended Questions (Appendix C). Some were derived from previously validated questionnaires, albeit in high-income countries only, some came from… | |
| method — evidence | — “A selection of articles ( n = 2933) were re-screened for this purpose. Keyword searches included: Search 1: ‘Survey’ and any one of ‘accept/barrier/refus/trust/missed/delay/confidence/partial/unsure/timeliness/hesitan’ Search 2: ‘Scale/Index/measurement/instrument/Questionnaire’ and any one of ‘Trust/Confidence/Hesitan’ These keywords were… | |
| object of study — evidence | — ““Vaccine hesitancy refers to a delay in acceptance or refusal of vaccination despite availability of vaccination services. Vaccine hesitancy is complex and context specific, varying across time, place, and vaccines. It is influenced by factors such as complacency, convenience and confidence”” | |
| research question — evidence | — “Tools are needed to assess the scope and scale of hesitancy issues by vaccine and setting. Ideally, a common survey tool that can be used globally would allow comparability across countries.” | |
| contribution — evidence | — “The Working Group developed a compendium of three different types of survey questions (See Appendices): Core Closed Questions (Appendix A); Likert Scale Questions (Appendix B); and a set of Open Ended Questions (Appendix C). Some were derived from previously validated questionnaires, albeit in high-income countries only, some came from… | |
| mechanism | the survey is built to separate three things a raw uptake figure cannot: REFUSAL, ACCESS FAILURE, and HESITANCY. `Counting only vaccine refusers will not capture hesitancy`, and the reasons for being unvaccinated must be assessed to tackle hesitancy `as distinct from access issues`— “When countries use questions presented in this paper to monitor hesitancy, several points must be considered in question selection: (1) Refusal is not the same as hesitancy, i.e. counting only vaccine refusers will not capture hesitancy” | mechanisms[0] |
| mechanism | and it is built to be VACCINE-SPECIFIC, because the construct is: hesitancy `may be specific to one or some, but not all, vaccines`, so a survey answer must not be generalised across vaccines unless the question said so— “(3) Vaccine hesitancy may be specific to one or some, but not all, vaccines, so interpretation of surveys should not generalize findings to all vaccines unless that is stated in the survey response.” | mechanisms[1] |
| extends | macdonald2015's definition of vaccine hesitancy and its Determinants Matrix - this paper is the instrument for that definition, by the same working group, in the adjacent article of the same supplement— ““Vaccine hesitancy refers to a delay in acceptance or refusal of vaccination despite availability of vaccination services. Vaccine hesitancy is complex and context specific, varying across time, place, and vaccines. It is influenced by factors such as complacency, convenience and confidence”” | claim_relations[0] |
| supports | the Global Vaccine Action Plan's Strategic Objective 2 indicators - which the 2012 pilot was shaped to match before the construct was— “In the 2012 JRF pilot test, the focus was on vaccine confidence, rather than on the broader issues driving vaccine hesitancy, in order to be in harmony with the Global Vaccine Action Plan indicators.” | claim_relations[1] |
| extends | SAGE's own final report, whose validation warning the paper quotes against its own compendium— “In the final report on the work on vaccine hesitancy, SAGE “encouraged validation of the developed compendium of survey questions on vaccine hesitancy, which have been assessed and validated only in some high-income countries or not at all.” | claim_relations[2] |
| sense | vaccine hesitancy, AS QUOTED HERE - `refers to a delay in acceptance or refusal of vaccination despite availability of vaccination services ... time, place, and vaccines`. Two words apart from macdonald2015's own text, which says `delay` and `place and`— ““Vaccine hesitancy refers to a delay in acceptance or refusal of vaccination despite availability of vaccination services. Vaccine hesitancy is complex and context specific, varying across time, place, and vaccines. It is influenced by factors such as complacency, convenience and confidence”” | senses[0] |
| sense | vaccine hesitancy, AS RESTATED IN THE DISCUSSION - `delay in acceptance or refusal of vaccines despite availability of vaccine services`. THIS IS THE NARROW READING macdonald2015 EXPLICITLY DECLINED, appearing in the paper that builds the instrument. Three versions of one definition, two of them in this record— “Vaccine hesitancy is defined as _delay in acceptance or refusal of vaccines despite availability of vaccine services_” | senses[1] |
| sense | hesitancy vs REFUSAL vs ACCESS - the three the instrument exists to separate. `Refusal is not the same as hesitancy, i.e. counting only vaccine refusers will not capture hesitancy`, and hesitancy must be assessed `as distinct from access issues`. A raw uptake number confounds all three | senses[2] |
| sense | `vaccine confidence` - WHAT THE 2012 INSTRUMENT ACTUALLY MEASURED, chosen `rather than the broader issues driving vaccine hesitancy` and `in order to be in harmony with the Global Vaccine Action Plan indicators`. The 2013 revision widened it back to complacency and convenience Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | senses[3] |
| sense | `a survey question about vaccine hesitancy` - OPERATIONALLY, whatever two keyword searches returned from 2,933 re-screened articles: `Survey` with any of accept/barrier/refus/trust/missed/delay/confidence/partial/unsure/timeliness/hesitan, or Scale/Index/measurement/instrument/Questionnaire with any of Trust/Confidence/Hesitan Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | senses[4] |
| control | whether the instrument counts refusal, or access failure, as hesitancy — partial Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. — rules out both confounds AT THE LEVEL OF INSTRUCTION - the paper states that refusal is not hesitancy and that hesitancy must be assessed as distinct from access - but no item, scoring rule or threshold is given that would separate them in a returned survey Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | controls[0] |
| control | whether the questions have been validated — failed Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. — rules out nothing, declared three times over: 'few have been validated', 'most are predominately designed for high-income settings', and SAGE's own report says they are validated 'only in some high-income countries or not at all' Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | controls[1] |
| control | whether the item pool covers the construct it is mapped onto — failed Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. — rules out nothing - the questions 'do not address all the determinants in the Vaccine Hesitancy Matrix', and the remedy offered is that more 'will need to be developed and validated' Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | controls[2] |
| control | the two JRF indicators were pilot-tested across the Americas, Europe and East, South and Central Africa, in four languages, before being proposed — partial Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. — rules out single-region wording effects as an explanation of the responses - the paper says the spread 'allowed for input from a broad range of high, middle and low-income countries' Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | controls[3] |
| weight | macdonald2015's definition of vaccine hesitancy and its Determinants Matrix - this paper is the instrument for that definition, by the same working group, in the adjacent article of the same supplement — 0.95 Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | claim_relations[0] |
| weight | the Global Vaccine Action Plan's Strategic Objective 2 indicators - which the 2012 pilot was shaped to match before the construct was — 0.7 Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | claim_relations[1] |
| weight | SAGE's own final report, whose validation warning the paper quotes against its own compendium — 0.6 Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | claim_relations[2] |
| edge | vaccine hesitancy —operationalised-as→ delay in acceptance or refusal of vaccines Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | concept_edges[0] |
| audit | vaccine hesitancy —distinct-from→ refusal — Audit 2026-09-28: DOUBTFUL - read against its full span and kept, but endpoint by anaphora: 'hesitancy' = vaccine hesitancy (previous sentence). Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | concept_edges[1] |
| edge | vaccine hesitancy —distinct-from→ access issues Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | concept_edges[2] |
| audit | vaccine confidence —distinct-from→ vaccine hesitancy — Audit 2026-09-28: DOUBTFUL - read against its full span and kept, but the span says the pilot focused on vaccine confidence rather than the broader issues driving hesitancy; distinct-from is loose. Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | concept_edges[3] |
| outcome | control — partial Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | controls[0] |
| outcome | control — failed Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | controls[1] |
| outcome | control — failed Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | controls[2] |
| outcome | control — partial Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | controls[3] |
| limitation | THE DEFINITION IS RESTATED IN A NARROWER FORM THAN ITS OWN SOURCE PAPER USES. macdonald2015 writes `delay in acceptance or refusal of vaccination despite availability of vaccination services`; this paper's Discussion writes `delay in acceptance or refusal of vaccines despite availability of vaccine services`. macdonald2015 spent a paragraph choosing the narrower NAME while keeping the broader SENSE, and the breadth lived in exactly those two words Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | limitations[0] |
| limitation | and the Introduction's block quotation differs from the source too, in two places: `A delay` for `delay`, and `time, place, and vaccines` for `time, place and vaccines`. Small, and they establish that THE DEFINITION IS BEING RE-TYPED RATHER THAN COPIED - which is how the third version becomes possible Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | limitations[1] |
| limitation | THE FIRST INSTRUMENT MEASURED SOMETHING ELSE ON PURPOSE: the 2012 pilot focused on vaccine confidence `rather than on the broader issues driving vaccine hesitancy`, `in order to be in harmony with the Global Vaccine Action Plan indicators`. The instrument was aligned to a programme's reporting framework before it was aligned to the construct Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | limitations[2] |
| limitation | the pilot it reports on had a 14% response rate - 13 of 94 countries - and the paper calls it `SUB-OPTIMAL` in its own first results sentence Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | limitations[3] |
| limitation | THE QUESTIONS ARE LARGELY UNVALIDATED AND THE PAPER SAYS SO THREE TIMES: `few have been validated`; `Most are predominately designed for high-income settings`; and the questions `do not address all the determinants in the Vaccine Hesitancy Matrix` Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | limitations[4] |
| limitation | and SAGE's own final report is quoted saying the compendium has been `assessed and validated only in some high-income countries or not at all` - a validation warning carried inside the paper that ships the instrument Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | limitations[5] |
| limitation | the items are of MIXED PROVENANCE and it is declared: some `derived from previously validated questionnaires, albeit in high-income countries only`, some from experts, and `others are newly proposed`. Three evidential grades in one compendium, distinguishable nowhere in the instrument itself Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | limitations[6] |
| limitation | and the construct is declared UNSTABLE IN TIME, which limits any single measurement: `A survey which reveals little hesitancy this year may have a different result next year` Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | limitations[7] |
| limitation | the funding disclosure is IDENTICAL to its companion paper's, and lands on the same word: the group monitoring `public confidence in Immunization Programs` took Novartis research funding and GSK meeting funding, and the first author consulted for GSK ON VACCINE CONFIDENCE Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | limitations[8] |
finding · quantity · variable · definition · key-term — grounded in the full text| finding | Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | content_tags.findings[0] |
| finding | Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | content_tags.findings[1] |
| finding | Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | content_tags.findings[2] |
| finding | Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | content_tags.findings[3] |
| finding | Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | content_tags.findings[4] |
| finding | Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | content_tags.findings[5] |
| finding | Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | content_tags.findings[6] |
| finding | Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | content_tags.findings[7] |
| finding | Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | content_tags.findings[8] |
| finding | Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | content_tags.findings[9] |
| finding | Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | content_tags.findings[10] |
| finding | Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | content_tags.findings[11] |
| quantity | articles re-screened to harvest candidate survey items Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | content_tags.quantities[0] |
| quantity | percent response to the first JRF pilot - 13 of 94 countries Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | content_tags.quantities[1] |
| variable | vaccine confidence Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | content_tags.variables[0] |
| definition | vaccine hesitancy Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | content_tags.definitions[0] |
| definition | Vaccine hesitancy Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | content_tags.definitions[1] |
| concept | vaccine hesitancy — not defined in this paper's own words; the construct being measured, quoted from the companion definition paper with two small textual departures and restated once in a narrower form Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | concepts[0] |
| concept | delay in acceptance or refusal of vaccines — not defined in this paper's own words; the Discussion's restatement of the definition - 'vaccines' and 'vaccine services' where the source paper wrote 'vaccination' and 'vaccination services' Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | concepts[1] |
| concept | refusal — not defined in this paper's own words; explicitly NOT hesitancy - counting refusers does not capture the construct Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | concepts[2] |
| concept | access issues — not defined in this paper's own words; the other thing a low uptake figure can mean; hesitancy must be assessed as distinct from it Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | concepts[3] |
| concept | vaccine confidence — not defined in this paper's own words; the narrower construct the 2012 pilot measured instead, to match a programme's indicator set Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | concepts[4] |
| concept | Vaccine Hesitancy Matrix — not defined in this paper's own words; the determinants framework the questions are mapped onto - and which the questions do not fully cover Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | concepts[5] |
| concept | JRF — not defined in this paper's own words; the annual WHO-UNICEF Joint Reporting Form that national immunization managers complete - the routine-monitoring vehicle the two indicators were piloted in Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher. | concepts[6] |
When we have changed our mind. Some entries in the table begin with a word in capitals and the reason for it. EVIDENCE CORRECTED — the finding still stands, but we had quoted the wrong sentence from the paper, and the quotation has been replaced with the right one. RETRACTED — the entry itself was wrong; it stays on the page, marked, with the reason, rather than being deleted. WITHDRAWN AND REPLACED — the entry was wrong, and a corrected version of it appears in the entries below. Each mark carries its own reason, in brackets, because the reasons differ from one entry to the next. An entry we have WITHDRAWN is removed from this page and kept in the record, with its reason. A line reading Audit and a date is a later re-reading of the entry against its whole sentence: DOUBTFUL means it was kept, and the reason says what is loose about it. Quotation marks inside the tagger's sentence. Where a tag is the tagger's own sentence, a phrase in quotation marks inside it is borrowed from the paper — the tagger's wording around it is not. The paper's own sentence is the evidence quote for that row; on this page it is withheld with the article, and the article is at its publisher. Nothing inside quotation marks anywhere on this page is ours: if it is quoted, it is the paper's. Whose words a concept carries. A concept entry records a term the paper itself uses, so the term, the sense given for it, and its evidence are the paper's own words, quoted where the paper fixes them. This is the opposite of a sense entry in the tag table, which is the tagger's sentence about how the paper uses a term. Where a concept entry could not be grounded in the paper's words, the entry says so on its own row.
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