Abstract
BackgroundAcceptance of vaccines is an important predictor of vaccine uptake. This has public health implications as those who are not vaccinated are at a higher risk of infection from vaccine preventable diseases. We aimed to examine how parental attitudes and beliefs towards childhood vaccination were measured in questionnaires through a systematic review of the literature.MethodsWe systematically reviewed the literature to identify primary research studies using tools to measure vaccine attitudes and beliefs, published between January 2012 and May 2018. Studies were included if they involved a quantitative survey of the attitudes and beliefs of parents about vaccinations recommended for children. We undertook a synthesis of the results with a focus on evaluating the tools used to measure hesitancy.ResultsA total of 116 studies met the inclusion criteria, 99 used a cross sectional study design, 5 used a case control study design, 4 used a pre-post study design and 8 used mixed methods study designs. Sample sizes of included studies ranged from 49 to 12,259. The most commonly used tool was the Parent Attitudes about Childhood Vaccines (PACV) Survey (n = 7). The most common theoretical framework used was the Health Belief Model (n = 25). Questions eliciting vaccination attitudes and beliefs varied widely.ConclusionsThere was heterogeneity in the types of questionnaires used in studies investigating attitudes and beliefs about vaccination in parents. Methods to measure parental attitudes and beliefs about vaccination could be improved with validated and standardised yet flexible instruments. The use of a standard set of questions should be encouraged in this area of study.
Highlights
Acceptance of vaccines is an important predictor of vaccine uptake
The largest recent questionnaires in the area include The Vaccine Confidence Project [12] which collected 65,819 responses across 67 countries [13], and the Wellcome Global Monitor 2018 [14], which collected more than 140,000 responses from 140 countries
Our aim was to examine how parental attitudes and beliefs towards childhood vaccination were measured in questionnaires through a systematic review of the literature
Summary
Acceptance of vaccines is an important predictor of vaccine uptake. This has public health implications as those who are not vaccinated are at a higher risk of infection from vaccine preventable diseases. The largest recent questionnaires in the area include The Vaccine Confidence Project [12] which collected 65,819 responses across 67 countries [13], and the Wellcome Global Monitor 2018 [14], which collected more than 140,000 responses from 140 countries. Both were based on the same set of questions, which included items about vaccine importance, effectiveness, safety, and religious compatibility. High variability in how constructs such as vaccine confidence are measured between different questionnaires makes it difficult to assess how attitudes and beliefs vary globally
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