Vaccine hesitancy among parents of preschoolers in Canada: a systematic literature review

Abstract

Objectives The purpose was to synthesize the available literature on what factors influence vaccine hesitancy of parents of preschoolers in Canada. Methods Databases (e.g., CINAHL, PubMed, OVID, Proquest) were searched for relevant research articles produced between January 2009 and October 2019. Articles were required to examine vaccine uptake in children aged 0-7, in the English language, and focused within a Canadian context. Articles were excluded if they focused on uptake of the influenza vaccine and if the study population was children with chronic health conditions. A total of 367 articles were reviewed and 12 met the criteria for inclusion in this review. Synthesis This review found that between 50% and 70% of children are completely vaccinated at 2 years old, with up to 97% having received at least one vaccine, and 2-5% receiving no vaccines. This review found that trust and access to health care providers is significantly associated with vaccine uptake, likely more important than parents' vaccine knowledge, and may compensate for challenges related to socioeconomic status and family dynamics. Conclusion Vaccine programs need to be created that are accessible to all families, with an awareness of the significant impact of trust on vaccine uptake. Future research should include consistent measures of vaccine uptake, and data from First Nation communities, and should examine how increased trust between health care providers and parents of preschool children would increase vaccine uptake in Canada. Résumé Objectifs Synthétiser la documentation disponible sur les facteurs qui influent sur l'hésitation vaccinale des parents d'enfants d'âge préscolaire au Canada. Méthode Des bases de données (CINAHL, PubMed, OVID, Proquest) ont été interrogées pour recenser les articles de recherche pertinents produits entre janvier 2009 et octobre 2019. Les articles devaient porter sur les taux de vaccination des enfants de la naissance à 7 ans, être rédigés en anglais et se concentrer sur le contexte canadien. Ont été exclus les articles portant sur les taux de vaccination contre l'influenza et ceux dont la population étudiée était constituée d'enfants atteints de problèmes de santé chroniques. Sur les 367 articles examinés, 12 répondaient aux critères d'inclusion dans notre revue systématique. Synthèse Selon la revue, entre 50 et 70 % des enfants sont entièrement vaccinés à l'âge de 2 ans, jusqu'à 97 % ont reçu au moins un vaccin, et entre 2 et 5 % n'en ont reçu aucun. La confiance envers les professionnels de santé et l'accès à ces professionnels présentent une corrélation significative avec les taux de vaccination; cette confiance et cet accès sont probablement plus importants que les connaissances des parents sur les vaccins, et ils pourraient compenser les difficultés liées au statut socioéconomique et aux dynamiques familiales.

Predictors of real-world parents’ acceptance to vaccinate their children against the COVID-19

“…Regarding children's vaccination, the role of parents is crucial as they decide whether to vaccinate their children. In a recent systematic review, only 50-70% of Canadian 2-year-old children have received all of the recommended vaccines (Schellenberg and Crizzle, 2020). Parental vaccination decisions are complex and a variety of factors influence parents' decision to vaccinate or not their children such as trust in access to healthcare providers, health perceptions and practices, healthcare system, attitudes toward vaccines, experiences, risks and effects of vaccination, religious issues, trust in science, information sources, emotions, etc.…”

“…Parental vaccination decisions are complex and a variety of factors influence parents’ decision to vaccinate or not their children such as trust in access to healthcare providers, health perceptions and practices, healthcare system, attitudes toward vaccines, experiences, risks and effects of vaccination, religious issues, trust in science, information sources, emotions, etc. (Caso et al, 2021; Dubé et al, 2018; Nurmi and Harman, 2021; Schellenberg and Crizzle, 2020).…”

Behavioural Science-Informed Strategies for Increasing COVID-19 Vaccine Uptake in Children and Youth

“…In the last two decades, there has been an increase in the development of strategies aiming to promote vaccine uptake in children and youth. We highlight four key strategies below; however, there are also necessary but insufficient conditions that are pivotal to all of the following strategies such as the availability of free vaccination, 21 the promotion of trust in vaccines and health services, 22 tailoring clear messaging regarding risks and benefits to developmental ages, and surveillance systems to monitor vaccine safety and uptake. 23 It is also important for any strategy to acknowledge and prepare for scenarios in which youth want to get vaccinated, but parents do not (or vice versa).…”

“…Healthcare provider recommendation is a well-researched strategy for increasing vaccine uptake in children. 22,[26][27][28][29] In order for healthcare providers to make an effective vaccine recommendation, it is necessary to inform, prompt and provide educational training and resources to providers about evolving COVID-19 vaccine recommendations and the rationale for vaccinating children and youth. 16,[30][31][32][33][34][35][36][37][38][39] It may be helpful to partner with primary care providers to administer vaccines in their offices, 40 and ensure parents are supported to have adequate paid time off for their children's appointments.…”

Disparities in Delaware Caregiver Beliefs about the COVID-19 Vaccine for their Children

“…4,5 The United States is still far from achieving herd immunity, with about 54% of Delawareans being fully vaccinated and uptake for COVID-19 vaccines declining. [6][7][8] Several studies in adults have demonstrated that Black adults, adults from rural areas, and adults from households with lower incomes have higher rates of COVID-19 vaccine hesitancy 6,[9][10][11][12][13] exacerbated by systemic issues of institutional racism, distrust of the healthcare system, misinformation, and complacency with the pandemic. 14,15 However, there have been only a handful of studies assessing caregiver hesitancy towards a COVID-19 vaccine for their children, 6,[16][17][18][19][20] with the most recent national survey showing that less than half of caregivers in the United States were likely to vaccinate their children against COVID-19 and increased hesitancy among parents of younger children those with lower educational status and non-Democratic affiliations.…”