Immunization is a global success story. It has saved millions of lives and prevented disease worldwide and millions more have been spared the permanent disabilities caused by diseases such as polio and the long-term morbidity caused by other diseases such as measles. Despite the compelling evidence of the public health and economic value of vaccines, vaccine hesitancy has become a growing concern globally. By calling into question the safety and efficacy of vaccines, vaccine hesitancy threatens the progress made in combating morbidity and mortality including efforts to introduce COVID-19 vaccines. This paper a) examines key factors that drive limited demand for vaccines and vaccine hesitancy, (b) highlights the role of demand promotion for immunization and of risk communication and community engagement to address those challenges, (c) discusses vaccine demand and hesitancy in Eastern Europe and Central Asia, and (d) makes recommendations for public health policy and programming for the introduction of the COVID-19 vaccine and beyond.

Recommendations include strengthen social listening and digital engagement to address the concerns of caregivers and healthcare professionals, improve the availability and use of social data for evidence-based programming, reinforce public trust in health institutions and service providers, mainstream demand for immunization, strengthen the communication competencies of health service providers, test and apply solutions based on behavioral insights to reinforce demand, engage regularly with local governments and local actors, and strengthen resilience and response capacities for diseases outbreaks and public health emergencies.

免疫是全球成功的故事。它挽救了全球数百万人的生命并预防了疾病，并且避免了数以百万计的人免于因脊髓灰质炎等疾病引起的永久性残疾以及由诸如麻疹等其他疾病引起的长期发病。尽管有令人信服的证据表明疫苗具有公共卫生和经济价值，但疫苗犹豫已成为全球范围内日益关注的问题。通过质疑疫苗的安全性和有效性，犹豫不决威胁了在防治发病率和死亡率方面取得的进展，包括引入COVID-19疫苗的努力。本文a）研究了导致对疫苗需求有限和疫苗犹豫不决的关键因素，（b）强调了促进免疫需求以及风险沟通和社区参与应对这些挑战的作用，

建议包括：加强社会倾听和数字参与，以解决护理人员和医疗保健专业人员的担忧；提高社会数据在循证编程中的可用性和使用性；增强公众对卫生机构和服务提供商的信任；对免疫接种的主流需求；加强沟通卫生服务提供者的能力，基于行为洞察力测试和应用解决方案以增强需求，定期与地方政府和地方参与者互动以及增强对疾病暴发和突发公共卫生事件的应变能力和应对能力。