[The challenges of continuing COVID-19 vaccination in a vaccine hesitancy scenario]

This study aimed to map controversies related to the interaction of the discontinuity of the vaccination schedule against COVID-19 and vaccine hesitancy in a municipality in the state of Pernambuco, Brazil. This research was guided by the cartography of controversies, a methodological perspective anchored in Actor-Network Theory. Interviews were conducted with 36 adults and older adults with an incomplete vaccination schedule, eight healthcare providers, and five health managers. A field diary was used to produce data. This study found three user profiles: confident, hesitant, and vaccinated by demand. In total, 21 users reported refusing to proceed with vaccination if recommended. Thematic groupings mapped three controversies: disputes over confidence in the COVID-19 vaccination scenario, information, and the expansion of vaccination coverage in the face of barriers to its access. The results highlighted that vaccine adherence was not synonymous with confidence in vaccination and that beliefs and feelings such as trust and fear were linked to personal experiences, fake news, and political and ideological debates, with distinct characteristics between the profiles. Collective responsibility would constitute an important element to strengthen vaccination and overcome vaccine barriers. This study showed the diversity of actors who experienced the discontinuity of the vaccination schedule against COVID-19, indicating the need for policies toward vaccination acceptance, the strengthening of vaccine confidence, and the expansion of adherence and vaccination coverage.