• Indah Hartati Faculty of Public Health, University of Indonesia
  • Yaslis Ilyas Faculty of Public Health, University of Indonesia
Keywords: Immunization, Hesitancy, Refusal, Herd Immunity


Immunization is a powerful public health strategy for improving children’s survival, not only by directly combating diseases that cause child mortality but also by providing a platform for other health services. Unfortunately, the rejection of immunization continues, not only in Indonesia but also in all parts of the world. Currently, the massive refusal of immunization often occurs mainly in  the  mass immunization  campaign.  This  study aims  to  provide  an  overview  to practitioners and observers of public health and policy makers in Indonesia about immunization refusal, its causes and consequences, and suggestions for overcoming this challenge. The method used in this study is literature review through comprehensive and non-systematic searches from several literature sources both nationally and internationally, using the terms “immunization refusal,” "vaccine refusal," "vaccine hesitancy," "vaccine confidence," "herd immunity," and "outbreak in  the  range  of  2008-2018,  with  the  results  that  the  main  reason  for  refusing immunization   is   risk/benefit;   knowledge/awareness;   and religion/culture/gender/socioeconomic. The incidence of illness and even death occurs in individuals/families/groups who refuse immunization to cause disturbing outbreaks. The need to recognize the problem of immunization refusal and its risks in a comprehensive manner to be able to formulate strategies and efforts for appropriate and effective public health..