SynthesisPloS one2017
Barriers of Influenza Vaccination Intention and Behavior - A Systematic Review of Influenza Vaccine Hesitancy, 2005 - 2016.
Synthesis in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 725 papers, 12 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
725 citing papers in PubMed, 12 syntheses or guidelines pooled it.
- Vaccine preferences and their role for vaccine confidence and uptake: a meta-ethnography.Global health action · 2026Pooled it
- Mpox vaccine acceptance and uptake in Africa: a systematic review and meta-analysis.BMC global and public health · 2026Pooled it
- A systematic review on vaccine developmental approaches: Evaluating efficacy, and addressing challenges of infectious diseases in the post-COVID-19 era.Virus research · 2026Pooled it
- COVID-19 vaccination hesitancy in pediatrics: a systematic review.Systematic reviews · 2026Pooled it
- Interventions targeting healthcare worker influenza vaccination: A systematic review.Human vaccines & immunotherapeutics · 2025Pooled it
- Knowledge, attitudes, and beliefs of pharmacists regarding vaccinations against influenza and pneumococci - a systematic review.Human vaccines & immunotherapeutics · 2025Pooled it
- Barriers to influenza vaccination in older adults with chronic diseases: Insights from a COM-B model-based meta-analysis.Human vaccines & immunotherapeutics · 2025Pooled it
- Pooled it
- Factors influencing adolescents' decision-making about COVID-19 vaccination: a systematic review with qualitative synthesis.Frontiers in public health · 2025Pooled it
- Vaccine hesitancy educational interventions for medical students: A systematic narrative review in western countries.Human vaccines & immunotherapeutics · 2024Pooled it
- The effect of alcohol, tobacco, and other drug use on vaccine acceptance, uptake, and adherence: a systematic review.Alcohol and alcoholism (Oxford, Oxfordshire) · 2024Pooled it
- Global prevalence and determinants associated with the acceptance of monkeypox vaccination.Narra J · 2024Pooled it
- Impact of multifaceted health education on influenza vaccination health literacy in primary school students: a cluster randomized controlled trial.BMC medicine · 2025Trial
- Digital Health Intervention on Awareness of Vaccination Against Influenza Among Adults With Diabetes: Pragmatic Randomized Follow-Up Study.Journal of medical Internet research · 2025Trial
- Pediatric practice experiences with second dose influenza vaccination: An AAP Pediatric Research in Office Settings (PROS) Study.Public health · 2024Trial
- Influence of grandchildren on COVID-19 vaccination uptake among older adults in China: a parallel-group, cluster-randomized controlled trial.Nature aging · 2024Trial
- Infographics on risks associated with COVID-19 and the willingness to get the AstraZeneca vaccine: two randomized online experiments.BMC public health · 2024Trial
- The Association between Message Framing and Intention to Vaccinate Predictive of Hepatitis A Vaccine Uptake.International journal of environmental research and public health · 2024Trial
- Factors associated with influenza vaccine uptake and intention among public transportation drivers: A cross-sectional study from Lebanon.Human vaccines & immunotherapeutics · 2026Article
- Coverage and appropriateness of influenza vaccination in adults ≥ 60 y: Provider contribution and adherence to Italian national recommendations.Human vaccines & immunotherapeutics · 2026Article
665 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInfluenza vaccine hesitancy is a significant threat to global efforts to reduce the burden of seasonal and pandemic influenza. Potential barriers of influenza vaccination need to be identified to inform interventions to raise awareness, influenza vaccine acceptance and uptake.
objectiveThis review aims to (1) identify relevant studies and extract individual barriers of seasonal and pandemic influenza vaccination for risk groups and the general public; and (2) map knowledge gaps in understanding influenza vaccine hesitancy to derive directions for further research and inform interventions in this area.
methodsThirteen databases covering the areas of Medicine, Bioscience, Psychology, Sociology and Public Health were searched for peer-reviewed articles published between the years 2005 and 2016. Following the PRISMA approach, 470 articles were selected and analyzed for significant barriers to influenza vaccine uptake or intention. The barriers for different risk groups and flu types were clustered according to a conceptual framework based on the Theory of Planned Behavior and discussed using the 4C model of reasons for non-vaccination.
resultsMost studies were conducted in the American and European region. Health care personnel (HCP) and the general public were the most studied populations, while parental decisions for children at high risk were under-represented. This study also identifies understudied concepts. A lack of confidence, inconvenience, calculation and complacency were identified to different extents as barriers to influenza vaccine uptake in risk groups.
conclusionMany different psychological, contextual, sociodemographic and physical barriers that are specific to certain risk groups were identified. While most sociodemographic and physical variables may be significantly related to influenza vaccine hesitancy, they cannot be used to explain its emergence or intensity. Psychological determinants were meaningfully related to uptake and should therefore be measured in a valid and comparable way. A compendium of measurements for future use is suggested as supporting information.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.