Socio-behavioural factors influencing childhood vaccination intentions
and uptake: A systematic review of the literature.
Abstract
Abstract Background: There has been a decline in
childhood vaccination uptake, with reports indicating that 25 million
children missed out on one or more doses in 2021 . There is a
need to understand the socio-behavioural drivers of vaccination uptake
and to identify contextual and emerging factors that can inform
demand-creation interventions. Objective: This review examined
the social and behavioural factors influencing childhood vaccination
intentions and uptake globally. Methods: A comprehensive search
was carried out for published studies that presented data on patterns of
association between socio-behavioural factors and vaccination intentions
and uptake in children under five years. Studies were screened for
eligibility by two reviewers, and information was collected using a
standard data abstraction form. Findings: Out of 4462 records
identified in the search, 82 studies were included. Emerging factors
influencing vaccination uptake included gender-based factors like the
mother’s financial autonomy, the number of social and formal messengers
recommending vaccination, the proportion of non-conforming social
network members, and the role of decisional balance and conflict as a
moderator of the vaccination intention and action pathway.
Conclusion: The review identified multiple behavioural and
social constructs influencing vaccination intentions and uptake. The
diversity of influences underscores the complexity of relationships
between social-behavioural factors and vaccination uptake, which may be
contributing to low vaccination uptake. More context-specific research
is required to extend the geographical base and depth of evidence and to
evaluate highly localised socio-behavioural interventions.