Parental vaccine hesitancy: Recent evidences support the need to implement targeted communication strategies

Exploring health locus of control among vaccine-hesitant parents: a scoping review

OBJECTIVES

This scoping review aimed to explore the relationship between health locus of control (HLOC) and vaccine hesitancy among parents of children aged 0-18 years, focusing on the tools and methods used to assess these constructs.

DESIGN

The review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines and adhered to established methodologies for scoping reviews, including systematic searches across four electronic databases.

DATA SOURCES

PubMed, PsycINFO, Web of Science and CINAHL were searched using a comprehensive search strategy to identify relevant studies on 24 September 2024.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Studies were included if they examined HLOC and vaccine hesitancy in parents, measured these constructs with validated tools and focused on childhood vaccination.

DATA EXTRACTION AND SYNTHESIS

Data were extracted into a structured table capturing study characteristics, HLOC and vaccine hesitancy measurements, and key findings. Results were synthesised narratively to highlight associations and patterns.

RESULTS

Five studies involving a total of 11 758 parents and caregivers of children aged 0-18 years met inclusion criteria. Higher internal HLOC was consistently associated with lower vaccine hesitancy and higher compliance, while lower chance HLOC correlated with greater hesitancy. Powerful others HLOC (ie, trust in healthcare professionals) emerged as a key predictor of better vaccine adherence.

CONCLUSIONS

The findings suggest that internal HLOC and trust in healthcare providers are predictors of vaccine acceptance among parents. However, standardised tools and longitudinal studies are needed to further elucidate these relationships and inform targeted interventions to reduce vaccine hesitancy.

Parental Barriers and Sociodemographic Disparities in Childhood Vaccination Post-COVID-19 in Tennessee

INTRODUCTION

The COVID-19 pandemic disrupted routine childhood vaccinations schedules, posing significant challenges among underserved communities. Understanding how different sociodemographic groups in Tennessee perceive and navigate childhood vaccination barriers is critical for developing strategies to improve vaccination rates and reduce vulnerability to vaccine-preventable diseases.

METHODS

A cross-sectional survey was conducted to explore barriers to vaccination across diverse sociodemographic groups in Tennessee. Data were collected from caregivers/parents of children aged 18 years and younger across all 95 counties in Tennessee at community events and through partnerships with schools and other local organizations. Parental responses were analyzed to identify barriers in access, concern, and importance domains. The distribution of barriers across different sociodemographic groups such as race, income, education level, and insurance status was identified. Descriptive statistics, non-parametric tests, and log-binomial regressions were used to address the research objectives.

RESULTS

This study found that the most prominent barriers to childhood vaccination were concerns regarding vaccine safety and side effects. Significant differences in vaccine barriers were observed across racial and ethnic groups for access barriers (p < 0.001), concern barriers (p = 0.006), and importance barriers (p < 0.001). Parents with lower education levels, children without health insurance, and lower-income families faced disproportionate challenges across two of the three barrier domains studied (access and perceived importance of vaccines). Additionally, concern barriers (aPR = 0.998, p < 0.001) and importance barriers (aPR = 0.997, p < 0.001) were strongly associated with the parent-reported prevalence of up-to-date vaccination status.

CONCLUSIONS

Addressing parental vaccination barriers related to concern, access, and perceived importance is crucial, particularly for underserved populations including low-income families, uninsured parents, racial/ethnic minorities, and those with limited education. A sustained, equity-focused approach integrating scientific communication, community engagement, and policy interventions is essential for increasing vaccine uptake and ensuring equitable vaccination access.

Vaccine hesitancy in the vaccination of children in Brazil

Since 2016, there has been a decrease in vaccination coverage for the childhood schedule of the National Immunization Program (PNI) in Brazil. To identify the reasons for vaccine hesitancy, we conducted a household survey of 31,001 live-born children living in the 26 Brazilian state capitals and the Federal District in 2017 and 2018. Census tracts were stratified according to socioeconomic status, we interviewed parents and/or guardians to collect information on the mother, child, reasons for not vaccinating, and other data. To identify the determinants of vaccine hesitancy, were used the "5Cs" (confidence, complacency and convenience, communication and context). Confidence: 94.5 % of parents/guardians of children trust the vaccines; 98.4 % believe it is important to vaccinate their children, and 20,0 % believe that vaccines are associated with serious adverse events. Complacency: 96.7 % decided to vaccinate their children with all the vaccines recommended; 7.2 % experienced difficulties with vaccination (distance and opening hours of the vaccination service, lack of time, problems with the child's health) despite going to the vaccination appointment; 22.9 % did not vaccinate their children (vaccine unavailable, clinic closed, health care provider absent, fear of adverse events). Communication: 24.5 % decided not to take their child for vaccination because of the pandemic; 24.4 % feared a reaction to the vaccine, and 9.2 % did not have the vaccine recommended by their doctor or health care provider. Socioeconomic status: vaccine confidence was lower among mothers with low education levels and lower-income families. Conclusions: Operational difficulties in the health care network were the main reasons for vaccine hesitancy in Brazilian state capitals during the study period. Although the proportion of parents/guardians who do not vaccinate their children voluntarily is low, this is a problem that needs to be consider so that it does not increase over time due to the infodemic.