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Review

Underlying factors impacting vaccine hesitancy in high income countries: a review of qualitative studies

, , , , &
Pages 989-1004
Received 29 May 2018
Accepted 24 Oct 2018
Accepted author version posted online: 25 Oct 2018
Published online: 07 Nov 2018

ABSTRACT

Introduction. While the scientific consensus on the benefits of vaccination is unambiguous, there is a growing proportion of the population that is skeptical about vaccination. The idea that vaccination programs are losing their momentum concerns public health agencies throughout the world. Many studies assessing determinants of vaccine acceptance have been published in the last decade.

Areas covered. In this article, we review the existing qualitative literature on parents’ attitudes toward childhood vaccination. Studies were included if they: (1) focused on the views, decision-making, or experiences of caregivers (hereafter, referred to as ‘parents’) regarding vaccinations for young children; (2) used qualitative methods for both data and data analysis; (3) were conducted in countries that ranked ‘very high’ on the 2016 United Nations Human Development Index; and (4) had been peer-reviewed. Twenty-two (22) studies met our inclusion criteria and were reviewed, using the socio-ecological model as a conceptual framework.

Expert commentary. Parental vaccination decisions are complex and multi-dimensional. Experiences, emotions, routine ways of thinking, information sources, peers/family, risk perceptions, and trust, among other factors, inform parents’ attitudes and decision-making processes. Further research is needed in order to design evidence-informed responses to vaccine hesitancy appropriate to the setting, context, and hesitant subgroups.

Acknowledgments

We would like to thanks Mrs Mahée Lacourse, Institut national de santé publique du Québec, for her help in designing the search strategies and Mr Samuel Rompré for his help in revising the studies.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants, or patents received or pending, or royalties.

Reviewer disclosures

A reviewer on this manuscript has disclosed the following ‘I have previously received conference registration, airfare, and accommodation support from GSK. The research I undertook 5 years ago was funded by an unrestricted grant from Sanofi’.

Supplemental data

Supplemental data for this article can be accessed here.

Additional information

Funding

The paper was not funded.

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