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Journal Article
8335 Exploring parental refusal of childhood vaccinations
2025
Overview
Why did you do this work?Parental refusal of childhood vaccinations is an increasingly significant public health concern, contributing to the resurgence of vaccine-preventable diseases, particularly measles globally in 2023 and 2024.1 This complex phenomenon includes issues of parental rights, child welfare, and public health policy. Children, lacking the capacity for medical decision-making, rely on parental consent for immunisations, with capacity becoming more ambiguous in adolescence.2 The objectives of this literature review were to explore why parents refuse vaccinations and how healthcare practitioners can alleviate parents’ concerns, decrease barriers to access and improve childhood vaccination.What did you do?This review aimed to explore the factors influencing parental vaccine refusal and identify strategies to address this issue. A literature search was conducted using PubMed, using terms such as ‘parental refusal of childhood vaccinations’, ‘immunisations’, and ‘vaccine hesitancy’. ‘Parental refusal of childhood vaccinations’ generated 314 results; 171 of which were accessible full texts. Searches were also made to understand how to provide better education and information to parents using the terms ‘vaccination education’ and ‘childhood vaccination leaflets’.What did you find?Five major factors were found contributing to parental vaccine refusal: the impact of the MMR-autism controversy, religion, education, safety concerns (including allergies, side effects, and ingredients), and media influence.3 Evidence shows the COVID-19 pandemic has further complicated perceptions of vaccine safety and efficacy.4 The Human Papillomavirus (HPV) vaccine faces distinctive challenges due to associated stigma and the age of administration as demonstrated by studies in Japan.5Barriers to vaccination access include limited appointments after hours, varying education levels and limited access to evidence-based information. Research emphasises that healthcare professionals (HCPs) should facilitate open, informed discussions about childhood vaccinations and to refer parents to appropriate resources when necessary.Strategies to address vaccine hesitancy include nurturing non-confrontational conversations between HCPs and parents. It is essential to adopt a patient-centred care approach, while providing unbiased, evidence-based information through accessible materials. Improving parental education, offering flexible appointment times, and utilising IT systems for vaccination tracking were identified as potential solutions.6What does it mean?In conclusion, addressing parental vaccine refusal requires a multifaceted approach that acknowledges the influence of media, misconceptions, and cultural sensitivities on healthcare decisions. Implementing targeted strategies and fostering effective communication between HCPs and parents, can lead to significant improvements in childhood vaccination rates may be achieved, ultimately improving public health outcomes. It would be beneficial to conduct a meta-analysis for a more methodical approach to exploring effective methods to improve vaccine uptake.ReferencesAl-Tawfiq JA, Jain N, Tanasov A, Schlagenhauf P. Measles matter: recent outbreaks highlight the need for catch-up vaccination in Europe and around the globe. 2024.Barstow C, Shahan B, Roberts M. Evaluating medical decision-making capacity in practice. 2018.McKee C, Bohannon K. Exploring the reasons behind parental refusal of vaccines. 2016.Grills LA, Wagner AL. The impact of the COVID-19 pandemic on parental vaccine hesitancy: A cross-sectional survey. 2023.Shiomi M, Ueda Y, Abe H, Yagi A, Sakiyama K, Kimura T, et al. A survey of Japanese mothers on the effectiveness of the ministry of health, labor and welfare’s revised HPV vaccine leaflet. 2020.Deborah A Gust, et al. Parent attitudes toward immunizations and healthcare providers: the role of information. 2005.
