A systematic review of factors affecting vaccine uptake in young children.

Louise E Smith,Jenny Yiend,John Weinman,Richard Amlôt,G James Rubin

doi:10.1016/j.vaccine.2017.09.046

Louise E Smith, Jenny Yiend + Show 3 more

Open Access

https://doi.org/10.1016/j.vaccine.2017.09.046

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Journal: Vaccine	Publication Date: Sep 30, 2017
Citations: 303	License type: cc-by

Affiliation: King's College London, Public Health England

Abstract

Many parents make a conscious decision not to vaccinate their child. Multiple beliefs and perceptions surround this choice. If uptake of routine child vaccination is to increase, public health communications about vaccines must be informed by evidence on the factors affecting uptake. We conducted a systematic review to investigate psychological, social and contextual factors associated with uptake of routine vaccines in young children. Studies were included if they reported analyses of the association between psychological factors and uptake or included parents' self-reported reasons for or against vaccination. Our search identified 9110 citations after deduplication. Sixty-eight citations describing sixty-four studies were included in the review. The quality of the studies was mixed. There is strong evidence for an association between vaccination uptake and: not perceiving vaccines to cause adverse effects; general positive attitudes towards vaccination; positive vaccine recommendations; and perceiving fewer practical difficulties of vaccination. While there was good evidence for an association between vaccination and perceived susceptibility to the illness, evidence for an association between perceived severity of an illness and vaccination was weak. Other factors associated with vaccination include knowledge about the vaccine, social influences and trust in the healthcare profession. Having increased information about the vaccine was associated with vaccination, but the influence of different sources of information needs more research. Understanding which factors are consistently associated with the decision to vaccinate one's child is important to identify messages which should be targeted by public health communications about routine child vaccinations.

Highlights

In 2015 almost six million children died globally before the age of five [1]
While in developing countries lack of access to vaccination and family characteristics such as low education, literacy and socio-economic status make up the majority of reasons why children are not vaccinated [4], in developed countries parents make conscious decisions not to use readily available vaccines
Risk of bias was assessed using an adaptation of the Downs & Black [17] checklist, which is suitable for use in systematic reviews [18] and has been validated [19]

Summary

Introduction

In 2015 almost six million children died globally before the age of five [1]. Over half died from preventable infectious diseases [2]. Understanding how to encourage uptake is an important public health aim Many studies in this area are guided by an explicit theory of behaviour change If uptake of routine child vaccination is to increase, public health communications about vaccines must be informed by evidence on the factors affecting uptake. Method: We conducted a systematic review to investigate psychological, social and contextual factors associated with uptake of routine vaccines in young children. Studies were included if they reported analyses of the association between psychological factors and uptake or included parents’ self-reported reasons for or against vaccination. Conclusion: Understanding which factors are consistently associated with the decision to vaccinate one’s child is important to identify messages which should be targeted by public health communications about routine child vaccinations.

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