A systematic review on parental vaccine hesitancy for childhood immunizations in the European region: Can findings be generalized?
Trust in healthcare professionals is essential in addressing vaccine hesitancy among parents, but tailored strategies are necessary due to varying cultural and socioeconomic factors.
Where it sits
this study against the rest of the eloralintide corpusSummary and findings
This systematic review assessed parental vaccine hesitancy (VH) for childhood immunizations across the WHO European Regions, synthesizing evidence from 49 articles published between January 2015 and December 2024. The review identified trust in healthcare professionals as a key factor influencing VH, while fear of side effects and logistical barriers negatively impacted vaccination decisions. Not reported in abstract.
Abstract
Vaccine hesitancy (VH) for childhood immunizations has been widely studied, but no review has synthesized evidence across Europe. This review addresses that gap using both qualitative and quantitative perspectives. A systematic search on February 5th, 2025, was conducted in MEDLINE/PubMed and Web of Science to assess the generalizability of findings regarding parental VH regarding childhood vaccinations (excluding HPV and Influenza) across the WHO European Regions. Forty-nine articles published between January 2015 and December 2024 in English, Dutch or French were included. Using WHO's 3C model (confidence, convenience, complacency), trust in healthcare professionals (HCPs) emerged as a key factor, while fear of side effects, logistical barriers and low perceived disease risk negatively influenced decisions. Demographic determinants were not generalizable across countries due to methodological and contextual (cultural, socioeconomic and healthcare system) differences, reinforcing the need for tailored approaches. VH remains multidimensional and context-dependent. WHO's 3C model is a useful tool for understanding VH. Tailored, country-specific strategies are needed, with strong HCP - caregiver relationships and policies addressing practical and socioeconomic barriers to ensure equitable access to childhood vaccination.
Background
This paper addresses the clinical question of vaccine hesitancy (VH) for childhood immunizations, a significant public health concern that has been widely studied but not synthesized across Europe. Prior studies have indicated various factors influencing VH, yet a comprehensive review was lacking. This study matters as it aims to fill that gap and provide insights into the generalizability of findings across different European contexts.
Methods
The study utilized a systematic review design, conducting a search on February 5th, 2025, in MEDLINE/PubMed and Web of Science. A total of 49 articles were included, focusing on parental vaccine hesitancy regarding childhood vaccinations, excluding HPV and Influenza. The review employed WHO's 3C model (confidence, convenience, complacency) as a framework for analysis.
Results
The review found that trust in healthcare professionals (HCPs) was a key factor influencing parental vaccine hesitancy, while fear of side effects, logistical barriers, and low perceived disease risk negatively impacted vaccination decisions. Specific numeric findings were not reported in the abstract.
Interpretation
The findings suggest that while trust in HCPs is crucial, the multifaceted nature of vaccine hesitancy requires tailored strategies that consider cultural, socioeconomic, and healthcare system differences. The effect sizes of the identified factors were not quantified in the abstract, making it difficult to assess their clinical significance. The limitations of the review, including the lack of generalizability of demographic determinants, suggest that caution should be exercised when applying these findings broadly.
Key findings
- 49 articles included, published between January 2015 and December 2024.
- Trust in healthcare professionals emerged as a key factor influencing vaccine hesitancy.
- Fear of side effects negatively influenced vaccination decisions.
- Demographic determinants of vaccine hesitancy were not generalizable across countries.
Limitations
- 49 articles included, which may not represent all relevant studies.
- Demographic determinants not generalizable across countries.
- Methodological differences among studies may affect synthesis.
- Not all findings were quantified in the abstract.