THE PRICE OF MISINFORMATION: IMPACTS OF VACCINE HESITANCY ON PUBLIC HEALTH

Abstract

Vaccines are fundamental to public health, having eradicated diseases such as smallpox and polio. However, vaccine hesitancy has emerged as a global challenge, driven by cultural factors, misinformation, and institutional distrust, and is recognized by the WHO as one of the top threats to global health. In Brazil, the National Immunization Program (PNI), once a success model, has faced declining vaccination coverage since 2015 due to the spread of fake news, political polarization, and access barriers. This study, based on an integrative review, found that hesitancy stems from multiple factors: paradoxical distrust among highly educated groups, religious and political influence, and a false sense of security created by the historical success of vaccines. The COVID-19 pandemic intensified this crisis, with areas under denialist leadership recording vaccination rates 22% below the national average. Solutions require multifaceted approaches: evidence-based campaigns with positive emotional narratives; public policies linking social benefits to vaccination; digital technologies; and community engagement with local leaders. Brazil's Unified Health System (SUS), with its extensive reach, is well-positioned to lead this transformation but requires investments in professional training and real-time monitoring systems. Recovering vaccination coverage is achievable through integrated strategies combining scientific rigor, assertive policies, and social participation, preserving Brazil's legacy in collective health.