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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 socio-economic 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.

Conclusion

Il faudrait créer des programmes de vaccination accessibles à toutes les familles en tenant compte de l’effet significatif de la confiance sur les taux de vaccination. Les études futures devraient inclure des mesures cohérentes des taux de vaccination et des données provenant des communautés des Premières Nations, et elles devraient chercher à déterminer si une confiance accrue entre les professionnels de santé et les parents d’enfants d’âge préscolaire ferait augmenter les taux de vaccination au Canada.

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Correspondence to Alexander M. Crizzle.

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Schellenberg, N., Crizzle, A.M. Vaccine hesitancy among parents of preschoolers in Canada: a systematic literature review. Can J Public Health 111, 562–584 (2020). https://doi.org/10.17269/s41997-020-00390-7

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Keywords

  • Vaccine hesitancy
  • Acceptance
  • Uptake
  • Preschool immunizations
  • Canada
  • Systematic review

Mots-clés

  • Hésitation vaccinale
  • acceptation des vaccins
  • taux de vaccination
  • immunisations préscolaires
  • Canada
  • revue systématique