ArticleBMJ global health2021
Parent-level barriers to uptake of childhood vaccination: a global overview of systematic reviews.
Article in BMJ global health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 71 papers, 4 of them syntheses that pooled it.
What it found
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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.
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Who cites it
71 citing papers in PubMed, 4 syntheses or guidelines pooled it, 112 citations in OpenAlex.
- The role of gender in early childcare practices in low- and middle-income countries: a systematic review and meta-analysis.Journal of global health · 2026Pooled it
- Factors ınfluencing vaccine refusal in children: an umbrella review on COVID-19 and childhood vaccinations.BMC public health · 2026Pooled it
- Health communication strategies to address parental vaccine hesitancy regarding childhood vaccination in Nigeria: a systematic review.Frontiers in public health · 2026Pooled it
- Reasons given for non-vaccination and under-vaccination of children and adolescents in sub-Saharan Africa: A systematic review.Human vaccines & immunotherapeutics · 2022Pooled it
- School nurses' perceptions of providing the HPV vaccine to adolescents in undervaccinated communities in Stockholm: A qualitative study.Human vaccines & immunotherapeutics · 2026Article
- Improving paediatric immunisation coverage rates: a position paper of the European Academy of Paediatrics.The Lancet regional health. Europe · 2026Review
- Factors Associated with Immunization Status Among Myanmar Migrant Children in Northern Thailand: A Community-Based Cross-Sectional Study.Medical sciences (Basel, Switzerland) · 2026Article
- Parent-Reported Influenza Vaccination Uptake, Hesitancy and Willingness for In-School Children: Survey Findings From Shenzhen, China With Free Vaccination Services.Tropical medicine & international health : TM & IH · 2026Article
- Article
- Assessing Geographic Inequalities in Childhood Immunisation Coverage: A Critical Scoping Review of Spatial Analysis Methods.Vaccines · 2026Article
- Facilitators and barriers to childhood immunization in Canada: a scoping review.BMC public health · 2026Article
- Barriers to Childhood Immunisation in Selected Zero-Dose Communities in Gauteng Province: A Qualitative Study.Vaccines · 2026Article
- Timely vaccination coverage and associated factors among children aged 12-23 months in Arbaminch Town, Ethiopia, 2024.BMC public health · 2026Article
- State of Inequality in Childhood Immunization: Monitoring Progress Across Low- and Middle-Income Countries over the Past Decade.Vaccines · 2026Article
- Gender and intersectional barriers to child immunization: findings from qualitative research in Nigeria.International journal for equity in health · 2026Article
- Impact of a community-led intervention on the uptake of childhood vaccines in Liverpool: a protocol for a synthetic control evaluation.BMJ open · 2026Article
- Understanding maternal decision-making for self-paid childhood vaccines a qualitative exploration of safety, information, and context.Frontiers in public health · 2026Article
- Differences in maternal acceptance of non-national immunization program vaccines between single-child and multiple-children households a hospital-based cross-sectional study.Frontiers in public health · 2026Article
- Parental concerns, behaviours, and attitudes associated with childhood vaccinations in Albania: a cross-sectional study.BMC public health · 2025Article
- Effect of short message service delivered health education messages on parental barriers to childhood immunisation in Borno State, Nigeria: a quasi-experimental study.African health sciences · 2025Article
11 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
8 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionUnderstanding barriers to childhood vaccination is crucial to inform effective interventions for maximising uptake. Published systematic reviews include different primary studies, producing varying lists of barriers. To make sense of this diverse body of literature, a comprehensive level of summary and synthesis is necessary. This overview of systematic reviews maps all potential parent-level barriers to childhood vaccination identified in systematic reviews. It synthesises these into a conceptual framework to inform development of a vaccine barriers assessment tool.
methodsWe applied Joanna Briggs methodology, searching the Epistemonikos review database and reference lists of included reviews to June 2020. Systematic reviews of qualitative or quantitative data on parent-level barriers to routine vaccination in preschool-aged children were included. Reviews addressing influenza, reporting non-modifiable determinants or reporting barriers not relevant to parents were excluded. Where possible, we extracted review details, barrier descriptions and the number, setting and design of primary studies. Two authors independently screened search results and inductively coded barrier descriptions.
resultsWe screened 464 papers, identifying 30 relevant reviews with minimal overlap. Fourteen reviews included qualitative and quantitative primary studies, seven included quantitative and seven included qualitative studies only. Two did not report included study designs. Two-thirds of reviews (n=20; 67%) only included primary studies from high-income countries. We extracted 573 barrier descriptions and inductively coded these into 64 unique barriers in six overarching categories: (1) Access, (2) Clinic or Health System Barriers, (3) Concerns and Beliefs, (4) Health Perceptions and Experiences, (5) Knowledge and Information and (6) Social or Family Influence.
conclusionsA global overview of systematic reviews of parent-level barriers to childhood vaccine uptake identified 64 barriers to inform development of a new comprehensive survey instrument. This instrument will assess both access and acceptance barriers to more accurately diagnose the reasons for under-vaccination in children in different settings.
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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.