[Hesitation and vaccination: reflections and theoretical-practical challenges for COVID-19 vaccination coverage in...

While not a phenomenon exclusive to the COVID-19 pandemic, vaccinal hesitation became more evident during this period, directly impacting vaccination coverage and exposing tensions among science, misinformation, and public health practices. The aim of this essay is to offer a critical description of the dimensions that influence the motivation to adhere to vaccination, analyzing (1) fears related to adverse events and the safety of vaccines, (2) the role of social media in the dissemination of misinformation, and (3) gaps in health communication as a barrier to the education of the population. A paradox emerges from observational data and reports from the primary health care: although the rate of initial refusal was low, the poor adherence to booster shots reveals residual hesitation. Therefore, the right to health communication, which is understood as a practical-methodological axis, is fundamental to the realization of the right to health in the Brazilian Unified National Health System. Strategies based on critical dialogue, transparency, and social participation can enhance vaccination coverage, strengthening not only the response to critical periods of health emergencies, but also collective pacts in public health.