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. 2021 Oct 27;10(10):CD013265.
doi: 10.1002/14651858.CD013265.pub2.

Factors that influence parents' and informal caregivers' views and practices regarding routine childhood vaccination: a qualitative evidence synthesis

Affiliations

Factors that influence parents' and informal caregivers' views and practices regarding routine childhood vaccination: a qualitative evidence synthesis

Sara Cooper et al. Cochrane Database Syst Rev. .

Abstract

Background: Childhood vaccination is one of the most effective ways to prevent serious illnesses and deaths in children. However, worldwide, many children do not receive all recommended vaccinations, for several potential reasons. Vaccines might be unavailable, or parents may experience difficulties in accessing vaccination services; for instance, because of poor quality health services, distance from a health facility, or lack of money. Some parents may not accept available vaccines and vaccination services. Our understanding of what influences parents' views and practices around childhood vaccination, and why some parents may not accept vaccines for their children, is still limited. This synthesis links to Cochrane Reviews of the effectiveness of interventions to improve coverage or uptake of childhood vaccination.

Objectives: - Explore parents' and informal caregivers' views and practices regarding routine childhood vaccination, and the factors influencing acceptance, hesitancy, or nonacceptance of routine childhood vaccination. - Develop a conceptual understanding of what and how different factors reduce parental acceptance of routine childhood vaccination. - Explore how the findings of this review can enhance our understanding of the related Cochrane Reviews of intervention effectiveness.

Search methods: We searched MEDLINE, Embase, CINAHL, and three other databases for eligible studies from 1974 to June 2020.

Selection criteria: We included studies that: utilised qualitative methods for data collection and analysis; focused on parents' or caregivers' views, practices, acceptance, hesitancy, or refusal of routine vaccination for children aged up to six years; and were from any setting globally where childhood vaccination is provided.

Data collection and analysis: We used a pre-specified sampling frame to sample from eligible studies, aiming to capture studies that were conceptually rich, relevant to the review's phenomenon of interest, from diverse geographical settings, and from a range of income-level settings. We extracted contextual and methodological data from each sampled study. We used a meta-ethnographic approach to analyse and synthesise the evidence. We assessed methodological limitations using a list of criteria used in previous Cochrane Reviews and originally based on the Critical Appraisal Skills Programme quality assessment tool for qualitative studies. We used the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) approach to assess our confidence in each finding. We integrated the findings of this review with those from relevant Cochrane Reviews of intervention effectiveness. We did this by mapping whether the underlying theories or components of trial interventions included in those reviews related to or targeted the overarching factors influencing parental views and practices regarding routine childhood vaccination identified by this review.

Main results: We included 145 studies in the review and sampled 27 of these for our analysis. Six studies were conducted in Africa, seven in the Americas, four in South-East Asia, nine in Europe, and one in the Western Pacific. Studies included urban and rural settings, and high-, middle-, and low-income settings. Many complex factors were found to influence parents' vaccination views and practices, which we divided into four themes. Firstly, parents' vaccination ideas and practices may be influenced by their broader ideas and practices surrounding health and illness generally, and specifically with regards to their children, and their perceptions of the role of vaccination within this context. Secondly, many parents' vaccination ideas and practices were influenced by the vaccination ideas and practices of the people they mix with socially. At the same time, shared vaccination ideas and practices helped some parents establish social relationships, which in turn strengthened their views and practices around vaccination. Thirdly, parents' vaccination ideas and practices may be influenced by wider political issues and concerns, and particularly their trust (or distrust) in those associated with vaccination programmes. Finally, parents' vaccination ideas and practices may be influenced by their access to and experiences of vaccination services and their frontline healthcare workers. We developed two concepts for understanding possible pathways to reduced acceptance of childhood vaccination. The first concept, 'neoliberal logic', suggests that many parents, particularly from high-income countries, understood health and healthcare decisions as matters of individual risk, choice, and responsibility. Some parents experienced this understanding as in conflict with vaccination programmes, which emphasise generalised risk and population health. This perceived conflict led some parents to be less accepting of vaccination for their children. The second concept, 'social exclusion', suggests that some parents, particularly from low- and middle-income countries, were less accepting of childhood vaccination due to their experiences of social exclusion. Social exclusion may damage trustful relationships between government and the public, generate feelings of isolation and resentment, and give rise to demotivation in the face of public services that are poor quality and difficult to access. These factors in turn led some parents who were socially excluded to distrust vaccination, to refuse vaccination as a form of resistance or a way to bring about change, or to avoid vaccination due to the time, costs, and distress it creates. Many of the overarching factors our review identified as influencing parents' vaccination views and practices were underrepresented in the interventions tested in the four related Cochrane Reviews of intervention effectiveness.

Authors' conclusions: Our review has revealed that parents' views and practices regarding childhood vaccination are complex and dynamic social processes that reflect multiple webs of influence, meaning, and logic. We have provided a theorised understanding of the social processes contributing to vaccination acceptance (or not), thereby complementing but also extending more individualistic models of vaccination acceptance. Successful development of interventions to promote acceptance and uptake of childhood vaccination will require an understanding of, and then tailoring to, the specific factors influencing vaccination views and practices of the group(s) in the target setting. The themes and concepts developed through our review could serve as a basis for gaining this understanding, and subsequent development of interventions that are potentially more aligned with the norms, expectations, and concerns of target users.

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Conflict of interest statement

Sara Cooper: none known.

Bey‐Marrié Schmidt: none known.

Evanson Z Sambala: none known.

Alison Swartz: none known.

Christopher J Colvin: none known.

Natalie Leon: none known.

Charles S Wiysonge: none known.

Figures

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Conceptual richness 5‐point scale (adapted from the typology of qualitative findings developed by Sandelowski 2007)
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Flow diagram to illustrate analysis phases
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3
Types and definitions of qualitative research findings (drawing on Noblit 1988; Britten 2002; Malpass 2009; Sandelowski 2007)
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Second‐order findings organised by the third‐order themes
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5
Second‐order findings that contributed to each third‐order concept
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All second‐ and third‐order findings and their relationships
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Study flow diagram
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Matrix model applying key findings from the qualitative synthesis to studies included in the Cochrane Reviews of interventions

Update of

  • doi: 10.1002/14651858.CD013265

References

References to studies included in this review

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Leask 2006a {published data only}
    1. Leask J, Chapman S, Hawe P, Burgess M. What maintains parental support for vaccination when challenged by anti-vaccination messages? A qualitative study. Vaccine 2006;24(49-50):7238-45. - PubMed
Lewendon 2002 {published data only}
    1. Lewendon GJ, Maconachie M. Why are children not being immunised? Barriers to immunisation uptake in South Devon. Health Education Journal 2002;61(3):212-20.
Limaye 2020 {published data only}
    1. Limaye RJ, Malik F, Frew PM, Randall LA, Ellingson MK, O'Leary ST, et al. Patient decision making related to maternal and childhood vaccines: exploring the role of trust in providers through a relational theory of power approach. Health Education & Behavior 2020;47(3):449-56. - PubMed
Lugg 2015 {published data only}
    1. Lugg FV, Butler CC, Evans MR, Wood F, Francis NA. Parental views on childhood vaccination against viral gastroenteritis: a qualitative interview study. Family Practice 2015;32(4):456-61. - PubMed
Lupton 2011 {published data only}
    1. Lupton DA. ‘The best thing for the baby’: mothers’ concepts and experiences related to promoting their infants’ health and development. Health, Risk & Society 2011;13(7/8):637-51.
Mansuri 2003 {published data only}
    1. Mansuri FA, Baig LA. Assessment of immunization service in perspective of both the recipients and the providers: a reflection from focus group discussions. Journal of Ayub Medical College 2003;15(1):14-8. - PubMed
Manthiram 2014 {published data only}
    1. Manthiram K, Blood EA , Kuppuswamy V, Martins Y, Narayan A, Burmeister K, et al. Predictors of optional immunization uptake in an urban south Indian population. Vaccine 2014;32(27):3417-23. - PMC - PubMed
Marshall 1999 {published data only}
    1. Marshall S, Swerissen H. A qualitative analysis of parental decision making for childhood immunisation. Australian & New Zealand Journal of Public Health 1999;23(5):543-5. - PubMed
McCormick 1997 {published data only}
    1. McCormick LK, Bartholomew LK, Lewis MJ, Brown MW, Hanson IC. Parental perceptions of barriers to childhood immunization: results of focus groups conducted in an urban population. Health Education Research 1997;12(3):355-62. - PubMed
McKnight 2014 {published data only}
    1. McKnight J, Holt DB. Designing the Expanded Programme on Immunisation (EPI) as a service: prioritising patients over administrative logic. Global Public Health 2014;9(10):1152-66. - PubMed
McMurray 2004 {published data only}
    1. McMurray R, Cheater FM, Weighall A, Nelson C, Schweiger M, Mukherjee S. Managing controversy through consultation: a qualitative study of communication and trust around MMR vaccination decisions. British Journal of General Practice 2004;54(504):520-5. - PMC - PubMed
McNeil 2019 {published data only}
    1. McNeil DA, Mueller M, MacDonald S, McDonald S, Saini V, Kellner JD, et al. Maternal perceptions of childhood vaccination: explanations of reasons for and against vaccination. BMC Public Health 2019;19(1):49. - PMC - PubMed
Mendel‐Van Alstyne 2018 {published data only}
    1. Mendel-Van Alstyne JA, Nowak GJ, Aikin AL. What is 'confidence' and what could affect it?: a qualitative study of mothers who are hesitant about vaccines. Vaccine 2018;36(44):6464-72. - PubMed
Miller 2008 {published data only}
    1. Miller NK, Verhoef M, Cardwell K. Rural parents' perspectives about information on child immunization. Rural & Remote Health 2008;8(2):863. - PubMed
Millimouno 2006 {published data only}
    1. Leach M, Fairhead J. Vaccine Anxieties: Global Science, Child Health and Society. London (UK): Earthscan, 2007.
    1. Leach MA, Fairhead JR, Millimouno D, Diallo AA. New therapeutic landscapes in Africa: parental categories and practices in seeking infant health in the Republic of Guinea. Social Science & Medicine 2008;66(10):2157-67. - PubMed
    1. Millimouno D, Diallo AA, Fairhead J, Leach M. The social dynamics of infant immunisation in Africa: perspectives from the Republic of Guinea; 2006. Available at https://opendocs.ids.ac.uk/opendocs/bitstream/handle/20.500.12413/4062/W....
Mixer 2007 {published data only}
    1. Mixer RE, Jamrozik K, Newsom D. Ethnicity as a correlate of the uptake of the first dose of mumps, measles and rubella vaccine. Journal of Epidemiology & Community Health 2007;61(9):797-801. - PMC - PubMed
Mossey 2019 {published data only}
    1. Mossey S, Hosman S, Montgomery P, McCauley K. Parents' experiences and nurses' perceptions of decision-making about childhood immunization. Canadian Journal of Nursing Research = Revue Canadienne de Recherche en Sciences Infirmieres 2019;Apr 30:844562119847343. - PubMed
New 1991 {published data only}
    1. New SJ, Senior ML. "I don't believe in needles": qualitative aspects of a study into the uptake of infant immunisation in two English health authorities. Social Science & Medicine 1991;33(4):509-18. - PubMed
Niederhauser 2007 {published data only}
    1. Niederhauser VP, Markowitz M. Barriers to immunizations: multiethnic parents of under- and unimmunized children speak. Journal of the American Academy of Nurse Practitioners 2007;19(1):15-23. - PubMed
Opel 2012 {published data only}
    1. Opel DJ, Robinson JD, Heritage J, Korfiatis C, Taylor JA, Mangione-Smith R. Characterizing providers' immunization communication practices during health supervision visits with vaccine-hesitant parents: a pilot study. Vaccine 2012;30(7):1269-75. - PubMed
Pal 2014 {published data only}
    1. Pal M, Goodyear-Smith F, Exeter D. Factors contributing to high immunisation coverage among New Zealand Asians. Journal of Primary Health Care 2014;6(4):304-11. - PubMed
Paterson 2018a {published data only}
    1. Paterson P, Schulz W, Utley M, Larson HJ. Parents' experience and views of vaccinating their child against influenza at primary school and at the general practice. International Journal of Environmental Research & Public Health 2018;15(4):28. - PMC - PubMed
Payne 2011 {published data only}
    1. Payne DC, Humiston S, Opel D, Kennedy A, Wikswo M, Downing K, et al. A multi-center, qualitative assessment of pediatrician and maternal perspectives on rotavirus vaccines and the detection of Porcine circovirus. BMC Pediatrics 2011;11:83. - PMC - PubMed
Peretti‐Watel 2019 {published data only}
    1. Peretti-Watel P, Ward JK, Vergelys C, Bocquier A, Raude J, Verger P. 'I Think I Made The Right Decision ... I Hope I'm Not Wrong'. Vaccine hesitancy, commitment and trust among parents of young children. Sociology of Health & Illness 2019;41(6):1192-206. - PubMed
Petts 2004 {published data only}
    1. Petts J, Niemeyer S. Health risk communication and amplification: learning from the MMR vaccination controversy. Health, Risk & Society 2004;6(1):7-23.
    1. Petts J. Health, responsibility, and choice: contrasting negotiations of air pollution and immunisation information. Environment and Planning A: Economy and Space 2005;37(5):791-804.
Pihl 2017 {published data only}
    1. Pihl GT, Johannessen H, Ammentorp J, Jensen JS, Kofoed PE. "Lay epidemiology": an important factor in Danish parents' decision of whether to allow their child to receive a BCG vaccination. A qualitative exploration of parental perspectives. BMC Pediatrics 2017;17(1):194. - PMC - PubMed
Poltorak 2005 {published data only}
    1. Leach M, Fairhead J. Vaccine Anxieties: Global Science, Child Health and Society. London (UK): Earthscan, 2007.
    1. Poltorak M, Leach M, Fairhead J, Cassell J. 'MMR talk' and vaccination choices: an ethnographic study in Brighton. Social Science & Medicine 2005;61(3):709-19. - PubMed
    1. Poltorak M, Leach M, Fairhead J. MMR “choices” in Brighton: understanding public engagement with vaccination science and delivery; 2004. Available at https://opendocs.ids.ac.uk/opendocs/handle/20.500.12413/4115.
Reich 2016 {published data only}
    1. Reich J. Calling the Shots: Why Parents Reject Vaccines. New York (NY): New York University Press, 2016a.
    1. Reich JA. “I Have to Write a Statement of Moral Conviction. Can Anyone Help?”: parents’ strategies for managing compulsory vaccination laws. Sociological Perspectives 2018a;61(2):222-39.
    1. Reich JA. "We are fierce, independent thinkers and intelligent": social capital and stigma management among mothers who refuse vaccines. Social Science & Medicine 2018b;30:30. - PubMed
    1. Reich JA. Neoliberal mothering and vaccine refusal: imagined gated communities and the privilege of choice. Gender & Society 2014;28(5):679-704.
    1. Reich JA. Of natural bodies and antibodies: parents' vaccine refusal and the dichotomies of natural and artificial. Social Science & Medicine 2016b;157:103-10. - PubMed
Renne 2010 {published data only}
    1. Renne EP. Perspectives on polio and immunization in Northern Nigeria. Social Science & Medicine 2006;63(7):1857-69. - PubMed
    1. Renne EP. The Politics of Polio in Northern Nigeria. Bloomington (IN): Indiana University Press, 2010.
Rogers 1995 {published data only}
    1. Rogers A, Pilgrim D. Paper One. Immunisation and its discontents: an examination of dissent from the UK mass childhood immunisation programme. Health Care Analysis 1995b;3(2):99-107. - PubMed
    1. Rogers A, Pilgrim D. The risk of resistance: perspectives in the mass childhood immunization (MCI) programme. In: Gabe J, editors(s). Medicine, Health and Risk. Sociological Approaches. Oxford (UK): Blackwell, 1995a.
Romijnders 2019 {published data only}
    1. Romijnders KA, Van Seventer SL, Scheltema M, Van Osch L, Vries H, Mollema L. A deliberate choice? Exploring factors related to informed decision-making about childhood vaccination among acceptors, refusers, and partial acceptors. Vaccine 2019;37(37):5637-44. - PubMed
Ruijs 2012 {published data only}
    1. Ruijs WL, Hautvast JL, Van Ijzendoorn G, Van Ansem WJ, Van der Velden K, Hulscher ME. How orthodox Protestant parents decide on the vaccination of their children: a qualitative study. BMC Public Health 2012;12:408. - PMC - PubMed
Saada 2015 {published data only}
    1. Saada A, Lieu TA, Morain SR, Zikmund-Fisher BJ, Wittenberg E. Parents' choices and rationales for alternative vaccination schedules: a qualitative study. Clinical Pediatrics 2015;54(3):236-43. - PubMed
Schwarz 2009 {published data only}
    1. Schwarz NG, Gysels M, Pell C, Gabor J, Schlie M, Issifou S, et al. Reasons for non-adherence to vaccination at mother and child care clinics (MCCs) in Lambarene, Gabon. Vaccine 2009;27(39):5371-5. - PubMed
Sensarma 2015 {published data only}
    1. Sensarma P, Bhandari S, Kutty VR. Barriers to immunization among children of HIV-infected mothers in Kolkata, India: a qualitative study. Asia-Pacific Journal of Public Health 2015;27(2):NP1362-71. - PubMed
Shefer 1998 {published data only}
    1. Shefer A, Mezoff J, Caspari D, Bolton M, Herrick P. What mothers in the Women, Infants, and Children (WIC) program feel about WIC and immunization linkage activities. A summary of focus groups in Wisconsin. Archives of Pediatrics & Adolescent Medicine 1998;152(1):65-70. - PubMed
Shui 2005 {published data only}
    1. Shui I, Kennedy A, Wooten K, Schwartz B, Gust D. Factors influencing African-American mothers' concerns about immunization safety: a summary of focus group findings. Journal of the National Medical Association 2005;97(5):657-66. - PMC - PubMed
Sjogren 2017 {published data only}
    1. Sjogren E, Ask LS, Ortqvist A, Asp M. Parental conceptions of the rotavirus vaccine during implementation in Stockholm: a phenomenographic study. Journal of Child Health Care 2017;21(4):476-87. - PubMed
Smith 2017 {published data only}
    1. Newton P, Smith DM. Factors influencing uptake of measles, mumps and rubella (MMR) immunization in site-dwelling Gypsy, Roma and Traveller (G&T) communities: a qualitative study of G&T parents' beliefs and experiences. Child: Care, Health & Development 2017;43(4):504-10. - PubMed
    1. Smith D, Newton P. Structural barriers to measles, mumps and rubella (MMR) immunisation uptake in Gypsy, Roma and Traveller communities in the United Kingdom. Critical Public Health 2017;27(2):238-47.
Sobo 2016 {published data only}
    1. Sobo EJ, Huhn A, Sannwald A, Thurman L. Information curation among vaccine cautious parents: Web 2.0, pinterest thinking, and pediatric vaccination choice. Medical Anthropology 2016a;35(6):529-46. - PubMed
    1. Sobo EJ. Theorizing (vaccine) refusal: through the looking glass. Cultural Anthropology 2016b;31(3):342-50.
    1. Sobo EJ. What is herd immunity, and how does it relate to pediatric vaccination uptake? US parent perspectives. Social Science & Medicine 2016c;165:187-95. - PubMed
Stamidis 2019 {published data only}
    1. Stamidis KV, Bologna L, Bisrat F, Tadesse T, Tessema F, Kang E. Trust, communication, and community networks: how the CORE Group Polio project community volunteers led the fight against polio in Ethiopia's most at-risk areas. American Journal of Tropical Medicine and Hygiene 2019;101(4 Suppl):59-67. - PMC - PubMed
Swaney 2018 {published data only}
    1. Swaney SE, Burns S. Exploring reasons for vaccine-hesitancy among higher-SES parents in Perth, Western Australia. Health Promotion Journal of Australia 2018;09:09. - PubMed
Sychareun 2019 {published data only}
    1. Sychareun V, Rowlands L, Vilay P, Durham J, Morgan A. The determinants of vaccination in a semi-rural area of Vientiane City, Lao People's Democratic Republic: a qualitative study. Health Research Policy & Systems 2019;17(1):2. - PMC - PubMed
Syiroj 2019 {published data only}
    1. Syiroj ATR, Pardosi JF, Heywood AE. Exploring parents' reasons for incomplete childhood immunisation in Indonesia. Vaccine 2019;37(43):6486-93. - PubMed
Tabana 2016 {published data only}
    1. Tabana H, Dudley LD, Knight S, Cameron N, Mahomed H, Goliath C, et al. The acceptability of three vaccine injections given to infants during a single clinic visit in South Africa. BMC Public Health 2016;16:749. - PMC - PubMed
Tadesse 2009 {published data only}
    1. Tadesse H, Deribew A, Woldie M. Explorative assessment of factors affecting child immunization in Wonago district, Gedeo zone, South Ethiopia. Archives of Medical Science 2009;5(2):233-40.
Tadesse 2017 {published data only}
    1. Tadesse T, Getachew K, Assefa T, Ababu Y, Simireta T, Birhanu Z, et al. Factors and misperceptions of routine childhood immunization service uptake in Ethiopia: findings from a nationwide qualitative study. Pan African Medical Journal 2017;28:290. - PMC - PubMed
Tarrant 2003 {published data only}
    1. Tarrant M, Gregory D. Exploring childhood immunization uptake with First Nations mothers in north-western Ontario, Canada. Journal of Advanced Nursing 2003;41(1):63-72. - PubMed
    1. Tarrant M, Gregory D. Mothers' perceptions of childhood immunizations in First Nations communities of the Sioux Lookout Zone. Canadian Journal of Public Health. Revue Canadienne de Sante Publique 2001;92(1):42-5. - PMC - PubMed
Tarrant 2008 {published data only}
    1. Tarrant M, Thomson N. Secrets to success: a qualitative study of perceptions of childhood immunisations in a highly immunised population. Journal of Paediatrics & Child Health 2008;44(10):541-7. - PubMed
Tickner 2007 {published data only}
    1. Tickner S, Leman PJ, Woodcock A. 'It's just the normal thing to do': exploring parental decision-making about the 'five-in-one' vaccine. Vaccine 2007;25(42):7399-409. - PubMed
Tickner 2010 {published data only}
    1. Tickner S, Leman PJ, Woodcock A. Parents' views about pre-school immunization: an interview study in southern England. Child: Care, Health & Development 2010;36(2):190-7. - PubMed
Tomlinson 2013 {published data only}
    1. Tomlinson N, Redwood S. Health beliefs about pre-school immunisation. Diversity and Equality in Health and Care 2013;10(2):101-13.
Topuzoglu 2007 {published data only}
    1. Topuzoglu A, Ay P, Hidiroglu S, Gurbuz Y. The barriers against childhood immunizations: a qualitative research among socio-economically disadvantaged mothers. European Journal of Public Health 2007;17(4):348-52. - PubMed
Vandenberg 2015 {published data only}
    1. Vandenberg SY, Kulig JC. Immunization rejection in southern Alberta: a comparison of the perspectives of mothers and health professionals. Canadian Journal of Nursing Research 2015;47(2):81-96. - PubMed
Varghese 2013 {published data only}
    1. Varghese J, Raman KV, Ramanathan M. The interactions of ethical notions and moral values of immediate stakeholders of immunisation services in two Indian states: a qualitative study. BMJ Open 2013;3(3):01. - PMC - PubMed
Wang 2015 {published data only}
    1. Wang E, Baras Y, Buttenheim AM. "Everybody just wants to do what's best for their child": understanding how pro-vaccine parents can support a culture of vaccine hesitancy. Vaccine 2015;33(48):6703-9. - PMC - PubMed
Ward 2017 {published data only}
    1. Attwell K, Leask J, Meyer SB, Rokkas P, Ward P. Vaccine rejecting parents' engagement with expert systems that inform vaccination programs. Journal of Bioethical Inquiry 2017;14(1):65-76. - PubMed
    1. Attwell K, Meyer SB, Ward PR. The social basis of vaccine questioning and refusal: a qualitative study employing Bourdieu's concepts of 'capitals' and 'habitus'. International Journal of Environmental Research & Public Health 2018a;15(5):22. - PMC - PubMed
    1. Attwell K, Smith DT, Ward PR. 'The unhealthy other': how vaccine rejecting parents construct the vaccinating mainstream. Vaccine 2018b;36(12):1621-6. - PubMed
    1. Attwell K, Ward PR, Meyer SB, Rokkas PJ, Leask J. "Do-it-yourself": vaccine rejection and complementary and alternative medicine (CAM). Social Science & Medicine 2018c;196:106-14. - PubMed
    1. Ward PR, Attwell K, Meyer SB, Rokkas P, Leask J. Risk, responsibility and negative responses: a qualitative study of parental trust in childhood vaccinations. Journal of Risk Research 2018;21(9):1117-30.
White 1995 {published data only}
    1. White GE, Thomson AN. 'As every good mother should.' Childhood immunization in New Zealand: a qualitative study. Health & Social Care in the Community 1995;3(2):73-82.
Widayanti 2020 {published data only}
    1. Widayanti AW, Norris P, Green JA, Heydon S. Is expanding service through an outreach programme enough to improve immunisation uptake? A qualitative study in Indonesia. Global Public Health 2020;15(8):1168-81. - PubMed
Wilson 2000 {published data only}
    1. Wilson T. Factors influencing the immunization status of children in a rural setting. Journal of Pediatric Health Care 2000;14(3):117-21. - PubMed
Wilson 2008 {published data only}
    1. Wilson K, Barakat M, Vohra S, Ritvo P, Boon H. Parental views on pediatric vaccination: the impact of competing advocacy coalitions. Public Understanding of Science 2008;17(2):231-43. - PubMed
Zamir 2017 {published data only}
    1. Zamir CS, Israeli A. Knowledge, attitudes and perceptions about routine childhood vaccinations among Jewish ultra-orthodox mothers residing in communities with low vaccination coverage in the Jerusalem District. Maternal & Child Health Journal 2017;21(5):1010-7. - PubMed
Zewdie 2016 {published data only}
    1. Zewdie A, Letebo M, Mekonnen T. Reasons for defaulting from childhood immunization program: a qualitative study from Hadiya zone, Southern Ethiopia. BMC Public Health 2016;16(1):1240. - PMC - PubMed

References to studies excluded from this review

Adams 2007 {published data only}
    1. Adams IF. The ethnographic evaluation of Michigan's high-risk hepatitis B vaccination program. NAPA Bulletin 2007;27(1):81-92.
Adams 2015 {published data only}
    1. Adams J, Bateman B, Becker F, Cresswell T, Flynn D, McNaughton R, et al. Effectiveness and acceptability of parental financial incentives and quasi-mandatory schemes for increasing uptake of vaccinations in preschool children: systematic review, qualitative study and discrete choice experiment. Health Technology Assessment (Winchester, England) 2015;19(94):1-176. - PMC - PubMed
Adams 2016 {published data only}
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Bell 2019 {published data only}
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Berezin 2016 {published data only}
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Blaisdell 2016 {published data only}
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Blume 2017 {published data only}
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Boas 2016 {published data only}
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Brooke 1999 {published data only}
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Brown 2017 {published data only}
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Canavati 2011 {published data only}
    1. Canavati S, Plugge E, Suwanjatuporn S, Sombatrungjaroen S, Nosten F. Barriers to immunization among children of migrant workers from Myanmar living in Tak province, Thailand. Bulletin of the World Health Organization 2011;89(7):528-31. - PMC - PubMed
Cassell 2006 {published data only}
    1. Cassell JA, Leach M, Poltorak MS, Mercer CH, Iversen A, Fairhead JR. Is the cultural context of MMR rejection a key to an effective public health discourse? Public Health 2006;120(9):783-94. - PubMed
Cawkwell 2016 {published data only}
    1. Cawkwell PB, Oshinsky D. Storytelling in the context of vaccine refusal: a strategy to improve communication and immunisation. Medical Humanities 2016;42(1):31-5. - PubMed
Chung 2017 {published data only}
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Cohen 2000 {published data only}
    1. Cohen LL, Manimala R, Blount RL. Easier said than done: what parents say they do and what they do during children's immunizations. Children's Health Care 2000;29(2):79-86.
Conis 2014 {published data only}
    1. Conis E. Vaccine Nation. Chicago (IL): University of Chicago Press, 2014.
Das 2000 {published data only}
    1. Das V, Das RK, Lester C. Disease control and immunisation: a sociological enquiry. Economic and Political Weekly 2000;35(8/9):625-32.
Das 2003 {published data only}
    1. Das J, Das S. Trust, learning, and vaccination: a case study of a North Indian village. Social Science & Medicine 2003;57(1):97-112. - PubMed
Deas 2019 {published data only}
    1. Deas J, Bean SJ, Sokolovska I, Fautin C. Childhood vaccine attitudes and information sources among Oregon parents and guardians. Health Promotion Practice 2019;20(4):529-38. - PubMed
Demolis 2018 {published data only}
    1. Demolis R, Botao C, Heyerdahl LW, Gessner BD, Cavailler P, Sinai C, et al. A rapid qualitative assessment of oral cholera vaccine anticipated acceptability in a context of resistance towards cholera intervention in Nampula, Mozambique. Vaccine 2018;36(44):6497-505. - PMC - PubMed
Elverdam 2011 {published data only}
    1. Elverdam B. ‘It is only a pinprick’ – (or is it?) – childhood vaccinations in general practice as ‘matter out of place’. Anthropology & Medicine 2011;18(3):339-50. - PubMed
Feldman‐Savelsberg 2000 {published data only}
    1. Feldman-Savelsberg P, Ndonko FT, Schmidt-Ehry B. Sterilizing vaccines or the politics of the womb: retrospective study of a rumor in Cameroon. Medical Anthropology Quarterly 2000;14(2):159-79. - PubMed
Feldman‐Savelsberg 2005 {published data only}
    1. Feldman-Savelsberg P, Ndonko FT, Yang S, Fine GA, Campion-Vincent V, Heath C. How rumor begets rumor: collective memory, ethnic conflict, and reproductive rumors in Cameroon. In: Fine GA, Campion-Vincent V, Heath C, editors(s). Rumor Mills: The Social Impact of Rumor and Legend. New York (NY): Routledge, 2005:141–158.
Fourn 2009 {published data only}
    1. Fourn L, Haddad S, Fournier P, Gansey R. Determinants of parents' reticence toward vaccination in urban areas in Benin (West Africa). BMC International Health & Human Rights 2009;9 Suppl 1:S14. - PMC - PubMed
Gardner 2010b {published data only}
    1. Gardner B, Davies A, McAteer J, Michie S. Beliefs underlying UK parents' views towards MMR promotion interventions: a qualitative study. Psychology Health & Medicine 2010;15(2):220-30. - PubMed
Gazmararian 2010 {published data only}
    1. Gazmararian JA, Orenstein W, Prill M, Hitzhusen HB, Coleman MS, Pazol K, et al. Maternal knowledge and attitudes toward influenza vaccination: a focus group study in metropolitan Atlanta. Clinical Pediatrics 2010;49(11):1018-25. - PubMed
Gesser‐Edelsburg 2016 {published data only}
    1. Gesser-Edelsburg A, Shir-Raz Y, Green MS. Why do parents who usually vaccinate their children hesitate or refuse? General good vs. individual risk. Journal of Risk Research 2016;19(4):405-24.
Ghinai 2013 {published data only}
    1. Ghinai I, Willott C, Dadari I, Larson HJ. Listening to the rumours: what the northern Nigeria polio vaccine boycott can tell us ten years on. Global Public Health 2013;8(10):1138-50. - PMC - PubMed
Godoy‐Ramirez 2019 {published data only}
    1. Godoy-Ramirez K, Bystrom E, Lindstrand A, Butler R, Ascher H, Kulane A. Exploring childhood immunization among undocumented migrants in Sweden - following qualitative study and the World Health Organizations Guide to Tailoring Immunization Programmes (TIP). Public Health 2019;171:97-105. - PubMed
Gottlieb 2016 {published data only}
    1. Gottlieb SD. Vaccine resistances reconsidered: vaccine skeptics and the Jenny McCarthy effect. BioSocieties 2016;11(2):152-74.
Gross 2015 {published data only}
    1. Gross K, Hartmann K, Zemp E, Merten S. 'I know it has worked for millions of years': the role of the 'natural' in parental reasoning against child immunization in a qualitative study in Switzerland. BMC Public Health 2015;15:373. - PMC - PubMed
Habib 2017 {published data only}
    1. Habib MA, Soofi SB, Ali N, Hussain I, Tabassum F, Suhag Z, et al. Knowledge and perceptions of polio and polio immunization in polio high-risk areas of Pakistan. Journal of Public Health Policy 2017;38(1):16-36. - PubMed
Helle 2001 {published data only}
    1. Helle S. Infusions of health: the popularity of vaccinations among Bissa in Burkina Faso. Anthropology and Medicine 2001;8(2/3):163-75.
Helps 2019 {published data only}
    1. Helps C, Leask J, Barclay L, Carter S. Understanding non-vaccinating parents' views to inform and improve clinical encounters: a qualitative study in an Australian community. BMJ Open 2019;9(5):e026299. - PMC - PubMed
Hilton 2007b {published data only}
    1. Hilton S, Hunt K, Petticrew M. MMR: marginalised, misrepresented and rejected? Autism: a focus group study. Archives of Disease in Childhood 2007;92(4):322-7. - PMC - PubMed
Hobson‐West 2003 {published data only}
    1. Hobson-West P. Understanding vaccination resistance: moving beyond risk. Health, Risk & Society 2003;5(3):273-83.
Hobson‐West 2004 {published data only}
    1. Hobson-West P. The construction of lay resistance to vaccination. In: Shaw I, Kauppinen K, editors(s). Constructions of Health and Illness. London (UK): Routledge, 2004:89-106.
Hobson‐West 2007 {published data only}
    1. Hobson-West P. 'Trusting blindly can be the biggest risk of all': organised resistance to childhood vaccination in the UK. Sociology of Health & Illness 2007;29(2):198-215. - PubMed
Holler 2012 {published data only}
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Holte 2012 {published data only}
    1. Holte JH, Mæstad O, Jani JV. The decision to vaccinate a child: an economic perspective from southern Malawi. Social Science & Medicine 2012;75(2):384. - PubMed
Ishita 2000 {published data only}
    1. Ishita G, Lester C. Normalcy and crisis in time of cholera: an ethnography of cholera in Calcutta. Economic and Political Weekly 2000;35(8/9):684-96.
Jackson 2017b {published data only}
    1. Jackson C, Bedford H, Cheater FM, Condon L, Emslie C, Ireland L, et al. Needles, jabs and jags: a qualitative exploration of barriers and facilitators to child and adult immunisation uptake among Gypsies, Travellers and Roma. BMC Public Health 2017;17(1):254. - PMC - PubMed
Jalloh 2019 {published data only}
    1. Jalloh MF, Bennett SD, Alam D, Kouta P, Lourenco D, Alamgir M, et al. Rapid behavioral assessment of barriers and opportunities to improve vaccination coverage among displaced Rohingyas in Bangladesh. Vaccine 2019;37(6):833-8. - PMC - PubMed
Jegede 2007 {published data only}
    1. Jegede AS. What led to the Nigerian boycott of the polio vaccination campaign? PLoS Medicine 2007;4(3):e73. - PMC - PubMed
Johnson 2013 {published data only}
    1. Johnson AM. Antivaccinationism: parental viewpoint. In: Chatterjee A, editors(s). Vaccinophobia and Vaccine Controversies of the 21st Century. New York (NY): Springer, 2013:129-46.
Judith 1983 {published data only}
    1. Judith E. Low immunization coverage in Yaounde, Cameroon: finding the problems. Medical Anthropology 1983;7(2):9-18.
Kennedy 2008 {published data only}
    1. Kennedy AM, Gust DA. Measles outbreak associated with a church congregation: a study of immunization attitudes of congregation members. Public Health Reports 2008;123(2):126-34. - PMC - PubMed
Kennedy 2014 {published data only}
    1. Kennedy C, Gray BC, Hogg R. 'Just that little bit of doubt': Scottish parents', teenage girls' and health professionals' views of the MMR, H1N1 and HPV vaccines. International Journal of Behavioral Medicine 2014;21(1):3-10. - PubMed
Keshet 2018 {published data only}
    1. Keshet Y, Popper-Giveon A. The undisciplined patient in neoliberal society: conscious, informed and intuitive health behaviours. Health, Risk and Society 2018;20(3-4):182-99.
Kitta 2012 {published data only}
    1. Kitta A. Vaccinations and Public Concern in History: Legend, Rumor, and Risk Perception. New York (NY): Routledge Taylor & Francis Group, 2012.
Kofoed 1992 {published data only}
    1. Kofoed PE, Zeitlyn S, Rahman AK, Gomes M, Nielsen B. Reasons for low tetanus immunization coverage in a hospital: a focus group investigation. Acta Paediatrica 1992;81(8):632. - PubMed
Kowal 2015 {published data only}
    1. Kowal SP, Jardine CG, Bubela TM. "If they tell me to get it, I'll get it. If they don't...": immunization decision-making processes of immigrant mothers. Canadian Journal of Public Health. Revue Canadienne de Sante Publique 2015;106(4):e230-5. - PMC - PubMed
Krishnamoorthy 2019 {published data only}
    1. Krishnamoorthy Y, Sivaranjini K, Gokul S, Gilbert M, Sonali S, Vishwanath N. Factors related to vaccine hesitancy during the implementation of Measles-Rubella campaign 2017 in rural Puducherry: a mixed-method study. Journal of Family Medicine and Primary Care 2019;8(12):3962-70. - PMC - PubMed
Kulig 2002 {published data only}
    1. Kulig JC, Meyer CJ, Hill SA, Handley CE, Lichtenberger SM, Mycks SL. Refusals and delay of immunization within Southwest Alberta. Canadian Journal of Public Health 2002;93(2):109-12. - PMC - PubMed
Largent 2012 {published data only}
    1. Largent MA. Vaccine: The Debate in Modern America. Baltimore (MD): Johns Hopkins University Press, 2012.
Larson 2018 {published data only}
    1. Larson WA, McCloskey L, Mwale M, Mwananyanda L, Murray K, Herman AR, et al. "When you are injected, the baby is protected:" assessing the acceptability of a maternal Tdap vaccine based on mothers' knowledge, attitudes, and beliefs of pertussis and vaccinations in Lusaka, Zambia. Vaccine 2018;36(21):3048-53. - PMC - PubMed
Lasseter 2020 {published data only}
    1. Lasseter G, Al-Janabi H, Trotter CL, Carroll FE, Christensen H. Understanding the role of peace of mind in childhood vaccination: a qualitative study with members of the general public. Vaccine 2020;38(10):2424-32. - PubMed
Lawrence 2014 {published data only}
    1. Lawrence HY, Hausman BL, Dannenberg CJ. Reframing medicine's publics: the local as a public of vaccine refusal. Journal of Medical Humanities 2014;35(2):111-29. - PubMed
Leask 2006b {published data only}
    1. Leask J, Sheikh-Mohammed M, Macintyre CR, Leask A, Wood NJ. Community perceptions about infectious disease risk posed by new arrivals: a qualitative study. Medical Journal of Australia 2006;185(11-12):591-3. - PubMed
Lee 2011 {published data only}
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Lester 2000 {published data only}
    1. Lester C, Niharika B. Social production of blame: case study of OPV-related deaths in West Bengal. Economic and Political Weekly 2000;35(8/9):709-17.
Letley 2018 {published data only}
    1. Letley L, Rew V, Ahmed R, Habersaat KB, Paterson P, Chantler T, et al. Tailoring immunisation programmes: using behavioural insights to identify barriers and enablers to childhood immunisations in a Jewish community in London, UK. Vaccine 2018;36(31):4687-92. - PubMed
Lind 2014 {published data only}
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Lind 2015 {published data only}
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Lindegger 2007 {published data only}
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Logullo 2008 {published data only}
    1. Logullo P, Barbosa de Carvalho H, Saconi R, Massad E. Factors affecting compliance with the measles vaccination schedule in a Brazilian city. Sao Paulo Medical Journal 2008;126(3):166-71. - PMC - PubMed
Luthy 2012 {published data only}
    1. Luthy KE, Beckstrand RL, Callister LC, Cahoon S. Reasons parents exempt children from receiving immunizations. Journal of School Nursing 2012;28(2):153-60. - PubMed
Luthy 2013 {published data only}
    1. Luthy KE, Beckstrand RL, Asay W, Hewett C. Vaccinating parents experience vaccine anxiety too. Journal of the American Association of Nurse Practitioners 2013;25(12):667-73. - PubMed
Machekanyanga 2017 {published data only}
    1. Machekanyanga Z, Ndiaye S, Gerede R, Chindedza K, Chigodo C, Shibeshi ME, et al. Qualitative assessment of vaccination hesitancy among members of the Apostolic Church of Zimbabwe: a case study. Journal of Religion & Health 2017;56(5):1683-91. - PMC - PubMed
Mack 1999 {published data only}
    1. Mack RW, Darden PM. Children's immunizations: the gap between parents and providers. Health Marketing Quarterly 1999;16(4):7-14. - PubMed
Maryam 2007 {published data only}
    1. Maryam Y. Polio vaccines - "No thank you!" barriers to polio eradication in northern Nigeria. African Affairs 2007;106(423):185-204.
Maya 2016 {published data only}
    1. Maya JG. Public misunderstanding of science? Reframing the problem of vaccine hesitancy. Perspectives on Science 2016;24(5):552-81.
McCoy 2019 {published data only}
    1. McCoy JD, Painter JE, Jacobsen KH. Perceptions of vaccination within a Christian homeschooling community in Pennsylvania. Vaccine 2019;37(38):5770-6. - PubMed
McDonald 2019 {published data only}
    1. McDonald P, Limaye RJ, Omer SB, Buttenheim AM, Mohanty S, Klein NP, et al. Exploring California's new law eliminating personal belief exemptions to childhood vaccines and vaccine decision-making among homeschooling mothers in California. Vaccine 2019;37(5):742-50. - PMC - PubMed
McGranahan 2016 {published data only}
    1. McGranahan C. Theorizing refusal: an introduction. Cultural Anthropology 2016;31(3):319-25.
McHale 2016 {published data only}
    1. McHale P, Keenan A, Ghebrehewet S. Reasons for measles cases not being vaccinated with MMR: investigation into parents' and carers' views following a large measles outbreak. Epidemiology and Infection 2016;144(4):870-5. - PubMed
McIntosh 2016 {published data only}
    1. McIntosh ED, Janda J, Ehrich JH, Pettoello-Mantovani M, Somekh E. Vaccine hesitancy and refusal. Journal of Pediatrics 2016;175:248-249.e1. - PubMed
Moulsdale 2017 {published data only}
    1. Moulsdale P. Parents' perceptions of influenza and why they accept or decline the nasal vaccine for their child. Nursing Children & Young People 2017;29(3):28-33. - PubMed
Murakami 2014 {published data only}
    1. Murakami H, Kobayashi M, Hachiya M, Khan ZS, Hassan SQ, Sakurada S. Refusal of oral polio vaccine in northwestern Pakistan: a qualitative and quantitative study. Vaccine 2014;32(12):1382-7. - PubMed
Namuigi 2005 {published data only}
    1. Namuigi P, Phuanukoonnon S. Barriers to measles immunization: the beliefs and attitudes of caregivers in Goroka, Eastern Highlands Province, Papua New Guinea. Papua New Guinea Medical Journal 2005;48(3-4):183-7. - PubMed
Navin 2016 {published data only}
    1. Navin M. Values and Vaccine Refusal: Hard Questions in Ethics, Epistemology, and Health Care. New York (NY): Routledge, 2016.
Newton 2006 {published data only}
    1. Newton S, Chantler T, Diggle L, Yu L, McCarthy N, Moxon R, et al. Parental acceptability of a pneumococcal conjugate vaccine in the UK childhood immunisation schedule. Primary Health Care 2006;16(8):34-9.
Nichter 1995 {published data only}
    1. Nichter M. Vaccinations in the Third World: a consideration of community demand. Social Science & Medicine 1995;41(5):617-32. - PubMed
Nuwaha 2000 {published data only}
    1. Nuwaha F, Mulindwa G, Kabwongyera E, Barenzi J. Causes of low attendance at national immunization days for polio eradication in Bushenyi district, Uganda. Tropical Medicine & International Health 2000;5(5):364-9. - PubMed
Offit 2011 {published data only}
    1. Offit PA. Deadly Choices: How the Anti-Vaccine Movement Threatens Us All. New York (NY): Basic Books, 2011.
Oku 2017 {published data only}
    1. Oku A, Oyo-Ita A, Glenton C, Fretheim A, Ames H, Muloliwa A, et al. Perceptions and experiences of childhood vaccination communication strategies among caregivers and health workers in Nigeria: a qualitative study. PLoS One 2017;12(11):e0186733. - PMC - PubMed
Omotara 2012 {published data only}
    1. Omotara BF, Okujagu T. Assessment of knowledge, attitude and practice of stakeholders towards immunization in Borno State, Nigeria: a qualitative approach. Journal of Community Medicine & Health Education for Health 2012;2(9):181.
Onnela 2016 {published data only}
    1. Onnela JP, Landon BE, Kahn AL, Ahmed D, Verma H, O'Malley AJ, et al. Polio vaccine hesitancy in the networks and neighborhoods of Malegaon, India. Social Science & Medicine 2016;153:99-106. - PubMed
Oude 2016 {published data only}
    1. Oude EA, Carbonnel F, Lognos B, Million E, Vallart M, Gagnon S, et al. Understanding parents' vaccination decisions to better help their decisions: a phenomenological qualitative study with French parents [Comprendre la decision vaccinale des parents pour mieux accompagner leurs choix: etude qualitative phenomenologique aupres des parents français]. Canadian Journal of Public Health. Revue Canadienne de Sante Publique 2016;106(8):e527-32. - PMC - PubMed
Patel 2007 {published data only}
    1. Patel MM, Janssen AP, Tardif RR, Herring M, Parashar UD. A qualitative assessment of factors influencing acceptance of a new rotavirus vaccine among health care providers and consumers. BMC Pediatrics 2007;7(32):5. - PMC - PubMed
Paterson 2018b {published data only}
    1. Paterson P, Chantler T, Larson HJ. Reasons for non-vaccination: parental vaccine hesitancy and the childhood influenza vaccination school pilot programme in England. Vaccine 2018;36(36):5397-401. - PubMed
Peprah 2016 {published data only}
    1. Peprah D, Palmer JJ, Rubin GJ, Abubakar A, Costa A, Martin S, et al. Perceptions of oral cholera vaccine and reasons for full, partial and non-acceptance during a humanitarian crisis in South Sudan. Vaccine 2016;34(33):3823-7. - PubMed
Plumridge 2008 {published data only}
    1. Plumridge E, Goodyear-Smith FA, Ross J. Parents and nurses during the immunization of children--where is the power? A conversation analysis. Family Practice 2008;25(1):14-9. - PubMed
Pool 2008 {published data only}
    1. Pool R, Mushi A, Schellenberg JA, Mrisho M, Alonso P, Montgomery C, et al. The acceptability of intermittent preventive treatment of malaria in infants (IPTi) delivered through the expanded programme of immunization in southern Tanzania. Malaria Journal 2008;7:213. - PMC - PubMed
Pugliese‐Garcia 2018 {published data only}
    1. Pugliese-Garcia M, Heyerdahl LW, Mwamba C, Nkwemu S, Chilengi R, Demolis R, et al. Factors influencing vaccine acceptance and hesitancy in three informal settlements in Lusaka, Zambia. Vaccine 2018;36(37):5617-24. - PMC - PubMed
Raithatha 2003 {published data only}
    1. Raithatha N, Holland R, Gerrard S, Harvey I. A qualitative investigation of vaccine risk perception amongst parents who immunize their children: a matter of public health concern. Journal of Public Health Medicine 2003;25(2):161-4. - PubMed
Renu 2000 {published data only}
    1. Renu A. Global-local dialectic in medico-administrative practice: case study of poliomyelitis. Economic and Political Weekly 2000;35(8/9):676-83.
Roberta 2012 {published data only}
    1. Roberta R. When 'to choose' is 'to care': informed dissent and the case of paediatric vaccinations. Suomen Antropologi – Journal of the Finnish Anthropological Society 2012;37(3):8-23.
Rodrigues 2014 {published data only}
    1. Rodrigues AD, Lorenzini E, da Silva FE. Mothers' knowledge regarding the vaccination program and factors which lead to delays in infant vaccination. Cogitare Enfermagem 2014;19(1):179-92.
Rodriguez 2016 {published data only}
    1. Rodriguez NJ. Vaccine-hesitant justifications: "Too Many, Too Soon," narrative persuasion, and the conflation of expertise. Global Qualitative Nursing Research 2016;3:2333393616663304. - PMC - PubMed
Rozbroj 2020 {published data only}
    1. Rozbroj T, Lyons A, Lucke J. Vaccine-hesitant and vaccine-refusing parents' reflections on the way parenthood changed their attitudes to vaccination. Journal of Community Health 2020;45(1):63-72. - PubMed
Rumetta 2020 {published data only}
    1. Rumetta J, Abdul-Hadi H, Lee Y. A qualitative study on parents' reasons and recommendations for childhood vaccination refusal in Malaysia. Journal of Infection and Public Health 2020;13(2):199-203. - PubMed
Sampson 2011 {published data only}
    1. Sampson R, Wong L, Macvicar R. Parental reasons for non-uptake of influenza vaccination in young at-risk groups: a qualitative study. British Journal of General Practice 2011;61(588):e386-91. - PMC - PubMed
Schaetti 2012 {published data only}
    1. Schaetti C, Ali SM, Hutubessy R, Khatib AM, Chaignat C, Weiss MG. Social and cultural determinants of oral cholera vaccine uptake in Zanzibar. Human Vaccines & Immunotherapeutics 2012;8(9):1223-9. - PMC - PubMed
Schoeppe 2017 {published data only}
    1. Schoeppe J, Cheadle A, Melton M, Faubion T, Miller C, Matthys J, et al. The immunity community: a community engagement strategy for reducing vaccine hesitancy. Health Promotion Practice 2017;18(5):654-61. - PubMed
Senier 2008 {published data only}
    1. Senier L. "It's your most precious thing": worst-case thinking, trust, and parental decision making about vaccinations. Sociological Inquiry 2008;78(2):207-29.
Serquina‐Ramiro 2001 {published data only}
    1. Serquina-Ramiro L, Kasniyah N, Inthusoma T, Higginbotham N, Streiner D, Nichter M, et al. Measles immunization acceptance in Southeast Asia: past patterns and future challenges. Southeast Asian Journal of Tropical Medicine & Public Health 2001;32(4):791-804. - PubMed
Shahbari 2020 {published data only}
    1. Shahbari NA, Gesser-Edelsburg A, Mesch GS. Perceived trust in the health system among mothers and nurses and its relationship to the issue of vaccinations among the Arab population of Israel: a qualitative research study. Vaccine 2020;38(1):29-38. - PubMed
Sherlock 2013 {published data only}
    1. Sherlock M, Cardoso M, Lélis A, Lopes M, Pereira M. Reasons for non-compliance of mothers to immunization schedule of children exposed to HIV. Revista da Rede de Enfermagem do Nordeste 2013;14(2):341-53.
Sobo 2015 {published data only}
    1. Sobo EJ. Social cultivation of vaccine refusal and delay among Waldorf (Steiner) school parents. Medical Anthropology Quarterly 2015;29(3):381-99. - PubMed
Sporton 2001 {published data only}
    1. Sporton RK, Francis SA. Choosing not to immunize: are parents making informed decisions? Family Practice 2001;18(2):181-8. - PubMed
Streefland 1999a {published data only}
    1. Streefland PH, Chowdhury AM, Ramos-Jimenez P. Quality of vaccination services and social demand for vaccinations in Africa and Asia. Bulletin of the World Health Organization 1999;77(9):722-30. - PMC - PubMed
Streefland 1999b {published data only}
    1. Streefland P, Chowdhury AM, Ramos-Jimenez P. Patterns of vaccination acceptance. Social Science & Medicine 1999;49(12):1705-16. - PubMed
Streefland 2001 {published data only}
    1. Streefland PH. Public doubts about vaccination safety and resistance against vaccination. Health Policy 2001;55(3):159-72. - PubMed
Swaney 2019 {published data only}
    1. Swaney SE, Burns S. Exploring reasons for vaccine-hesitancy among higher-SES parents in Perth, Western Australia. Health promotion journal of Australia 2019;30(2):143-52. - PubMed
Taylor 2010 {published data only}
    1. Taylor S, Shimp L. Using data to guide action in polio health communications: experience from the Polio Eradication Initiative (PEI). Journal of Health Communication 2010;15 Suppl 1:48-65. - PubMed
Taylor 2015 {published data only}
    1. Taylor S. Culture and behaviour in mass health interventions: lessons from the global polio eradication initiative. Critical Public Health 2015;25(2):192.
Thorpe 2021 {published data only}
    1. Thorpe M, Taylor J, Cole R. Parents' use of information accessed through social media to make immunisation decisions for their young children. Health Promotion Journal of Australia 2021;32(2):189-196. - PubMed
Uddin 2014 {published data only}
    1. Uddin MJ, Wahed T, Saha NC, Kaukab SS, Khan IA, Khan AI, et al. Coverage and acceptability of cholera vaccine among high-risk population of urban Dhaka, Bangladesh. Vaccine 2014;32(43):5690-5. - PubMed
Valido 2018 {published data only}
    1. Valido EM, Laksanawati IS, Utarini A. Acceptability of the dengue vaccination among parents in urban poor communities of Quezon City, Philippines before and after vaccine suspension. BMC Research Notes 2018;11(1):661. - PMC - PubMed
Varma 2008 {published data only}
    1. Varma GR, Kusuma YS. Immunization coverage in tribal and rural areas of Visakhapatnam district of Andhra Pradesh, India. Journal of Public Health 2008;16(6):389-97.
Velan 2016 {published data only}
    1. Velan B. Vaccine hesitancy as self-determination: an Israeli perspective. Israel Journal of Health Policy Research 2016;5:13. - PMC - PubMed
Visser 2016 {published data only}
    1. Visser O, Hautvast JL, Van der Velden K, Hulscher ME. Intention to accept pertussis vaccination for cocooning: a qualitative study of the determinants. PLoS One 2016;11(6):e0155861. - PMC - PubMed
Wahed 2013 {published data only}
    1. Wahed T, Kaukab SS, Saha NC, Khan IA, Khanam F, Chowdhury F, et al. Knowledge of, attitudes toward, and preventive practices relating to cholera and oral cholera vaccine among urban high-risk groups: findings of a cross-sectional study in Dhaka, Bangladesh. BMC Public Health 2013;13:242. - PMC - PubMed
Wang 2014 {published data only}
    1. Wang LD, Lam WW, Wu JT, Liao Q, Fielding R. Chinese immigrant parents' vaccination decision making for children: a qualitative analysis. BMC Public Health 2014;14:133. - PMC - PubMed
Watson 2007 {published data only}
    1. Watson PB, Yarwood J, Chenery K. Meningococcal B: tell me everything you know and everything you don't know. New Zealanders' decision-making regarding an immunisation programme. New Zealand Medical Journal 2007;120(1263):U2751. - PubMed
Whyte 2011 {published data only}
    1. Whyte MD, Whyte Iv J, Cormier E, Eccles DW. Factors influencing parental decision making when parents choose to deviate from the standard pediatric immunization schedule. Journal of Community Health Nursing 2011;28(4):204-14. - PubMed
Wilson 2019 {published data only}
    1. Wilson R, Paterson P, Larson HJ. Strategies to improve maternal vaccination acceptance. BMC Public Health 2019;19(1):342. - PMC - PubMed
Winslade 2017 {published data only}
    1. Winslade CG, Heffernan CM, Atchison CJ. Experiences and perspectives of mothers of the pertussis vaccination programme in London. Public Health 2017;146:10-14. - PubMed
You 2007 {published data only}
    1. You X, Kobayashi Y, Yang J, Zhu X, Liang X. Qualitative study of knowledge and behaviours related to tetanus toxoid immunization among women of childbearing age in rural China. Public Health 2007;121(3):227-30. - PubMed

References to studies awaiting assessment

Chowdhury 1999 {published data only}
    1. Chowdhury M, Aziz A, Bhuiya A. The 'Near Miracle' Revisited: Social Science Perspectives of the Immunization Programme in Bangladesh. Amsterdam (the Netherlands): Het Spinhuis, 1999.
Closser 2010 {published data only}
    1. Closser S. Chasing Polio in Pakistan: Why the World’s Largest Public Health Initiative May Fail. Nashville (TN): Vanderbilt University Press, 2010.
Kennell 2014 {published data only}
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Rogers 1994 {published data only}
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Additional references

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