Vaccination remains among the most effective public health interventions, but its impact increasingly depends on public trust and a reliable information environment. During the coronavirus disease 2019 (COVID-19) pandemic, misinformation became a major obstacle to vaccine uptake and disease control. The rapid development of generative artificial intelligence (AI)—including synthetic text generators, conversational chatbots, deepfake images, synthetic audio, and AI-generated videos—has changed how misinformation can be produced, personalized, and disseminated. This Perspective argues that AI-generated misinformation may represent a new stage in the evolution of the infodemic. Compared with earlier forms of vaccine misinformation, AI-generated content can be produced automatically, tailored to individual audiences, made visually persuasive, and distributed at unprecedented speed and scale. Drawing on historical vaccine controversies, health communication research, and epidemiological principles of herd immunity, we propose that AI-driven misinformation should be examined not only as a communication problem but also as a potential epidemiological risk factor that may weaken population immunity. The implications extend beyond vaccine hesitancy to the preparedness and resilience of public health systems during future pandemics. We discuss how anti-vaccination movements may change in the AI era and propose responses centered on trust-building, digital health literacy, information surveillance, and community engagement to support vaccine confidence and pandemic preparedness.
Objectives Immunization is considered one of the most successful and cost-effective public health interventions protecting communities from preventable infectious diseases. The Korean government set up a dedicated workforce for national immunization in 2003, and since then has made strides in improving vaccination coverage across the nation. However, some groups remain relatively vulnerable and require intervention, and it is necessary to address unmet needs to prevent outbreaks of communicable diseases. This study was conducted to characterize persistent challenges to vaccination.
Methods The study adopted a qualitative method in accordance with the Consolidated Criteria for Reporting Qualitative Research checklist. Three focus group interviews were conducted with 15 professionals in charge of vaccination-related duties. The interviews were conducted according to a semi-structured guideline, and thematic analysis was carried out. Data saturation was confirmed when the researchers agreed that no more new codes could be found.
Results A total of 4 main topics and 11 subtopics were introduced regarding barriers to vaccination. The main topics were vaccine hesitancy, personal circumstances, lack of information, and misclassification. Among them, vaccine hesitancy was confirmed to be the most significant factor impeding vaccination. It was also found that the factors hindering vaccination had changed over time and disproportionately affected certain groups.
Conclusions The study identified ongoing unmet needs and barriers to vaccination despite the accomplishments of the National Immunization Program. The results have implications for establishing tailored interventions that target context- and group-specific barriers to improve timely and complete vaccination coverage.
Summary
Citations
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