Parental confidence in vaccines since the COVID-19 pandemic: a qualitative meta-synthesis
DOI:
https://doi.org/10.15343/0104-7809.202549e17512025PKeywords:
Immunization, Vaccine Hesitancy, Child, SARS-CoV-2 InfectionAbstract
Parental hesitancy toward vaccines is associated with multiple factors—historical, cultural, and socioeconomic—along with new perspectives related to vaccine confidence since the COVID-19 pandemic. This study aimed to understand parents’ perceptions of the vaccination phenomenon and the influence of the COVID-19 pandemic period. A qualitative systematic review and meta-synthesis of the results were conducted. Searches were carried out in the Medline, Scopus, PubMed, Scielo, and Lilacs databases. The methodological quality of the studies was assessed using the Critical Appraisal Skills Programme (CASP). After applying inclusion criteria, nine studies comprised the meta-synthesis. Thematic synthesis followed the approach proposed by Thomas and Harden. Rumors and concerns about vaccine efficacy, distrust in government, and lack of perceived disease severity were associated with low confidence. Confidence and acceptance were related to protection, return to normal routines, disease severity, risk of infection, concern with comorbidities, and previous experiences. The media, government, community leaders, social networks, health organizations, and healthcare professionals were identified as influential actors in vaccination decisions. Strategies are needed to bring the population closer to scientific reality and to foster citizens’ confidence in vaccines.
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Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect Dis [Internet] 2020 Jun 12; [cited 2024 Jun 20]; 20(5):533–534. Available from: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30120-1/fulltext
Fiolet T, Kherabi Y, MacDonald CJ, Ghosn J, Peiffer-Smadja N. Comparing COVID-19 vaccines for their characteristics, efficacy and effectiveness against SARS-CoV-2 and variants of concern: a narrative review. Clin Microbiol Infect [Internet] 2022 Feb; [cited 2024 Jun 20]; 28(2):202–221. Available from: https://doi.org/10.1016/j.cmi.2021.10.005
Larson HJ, Jarrett C, Eckersberger E, Smith DMD, Paterson P. Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: A systematic review of published literature, 2007–2012. Vaccine [Internet] 2014 Apr 17; [cited 2024 Jun 21]; 32(19):2150–9. Available from: https://doi.org/10.1016/j.vaccine.2014.01.081
Gerussi V, Peghin M, Palese A, De Martino M, Graziano E, Chiappinotto S, et al. SARS-CoV-2 and influenza vaccine hesitancy during the COVID-19 pandemic in a dynamic perspective. Hum Vaccin Immunother [Internet] 2024 Jun 2; [cited 2024 Jun 21]; 20(1):2358565. Available from: https://doi.org /10.1080/21645515.2024.2358565
Souto EP, Fernandez MV, Rosário CA, Petra PC, Matta GC. Hesitação vacinal infantil e COVID-19: uma análise a partir da percepção dos profissionais de saúde. Cad. Saúde Pública [Internet] 11 de Mar de 2024; [acessado em 21 de Jun de 2024]; 40(3):e00061523. Disponível em: https://doi. org/10.1590/0102-311XPT061523
Zhang P, Wei M, Jing P, Li Z, Li J, Zhu F. COVID-19 in children: epidemic issues and candidate vaccines. Chin Med J [Internet] 2022 Jun 5; [cited 2024 Jun 21];135(11):1314-1324. Available from: https://doi.org/10.1097/cm9.0000000000002169
Girard IM, Ward P, Durey A, Lund S, Calache H, Baker SR, et al. Primary caregivers’ perceptions of factors influencing preschool children’s oral health: social practices perspective—a protocol for qualitative metasynthesis. BMJ Open [Internet] 2023 Apr 11; [cited 2024 Jun 21];13(4):e068444. Available from: https://doi.org/10.1136/bmjopen-2022-068444
Tong A, Flemming K, McInnes E, Oliver S, Craig J. Enhancing transparency in reporting the synthesis of qualitative research: ENTREQ. BMC Med Res Methodol [Internet] 2012 Nov 27; [cited 2024 Jun 21]; 12:181. Available from: https://doi.org/10.1186/1471-2288-12-181
Thomas J, Harden A. Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Med Res Methodol [Internet] 2008 Jul 10; [cited 2024 Jun 21]; 8:45. Available from: https://doi.org/10.1186/1471-2288-8-45
CASP - Critical Appraisal Skills Programme. [website]. CASP Qualitative Studies Checklist. [cited 2024 Jul 03]. Available from: https://casp-uk.net
Pelletier C, Gagnon D, Dubé E. “It’s not that I don’t trust vaccines, I just don’t think I need them”: Perspectives on COVID-19 vaccination. PLoS One [Internet] 2024 Feb 15; [cited 2024 Jul 03];19:e0293643–e0293643. Available from: https://doi.org/10.1371/journal.pone.0293643
Teixeira EP, Lynn FA, Souza MDLD. Guia para revisão sistemática de estudos observacionais. Texto Contexto Enferm [Internet] 13 de Mai 2024; [acessado em 03 de Jul de 2024]; 33:e20230221. Disponível em: https://doi.org/10.1590/1980-265X-TCE-2023-0221pt
PRISMA 2020 flow diagram. [website]. PRISMA statement. [cited 2024 Jul 03]. Available from: https://www.prisma-statement.org/prisma-2020-flow-diagram
Rajeh MT, Farsi DJ, Farsi NJ, Mosli HH, Mosli MH. Are parents’ willing to vaccinate their children against COVID-19? A qualitative study based on the Health Belief Model. Hum Vaccin Immunother [Internet] 2023 Feb 8; [cited 2024 Jul 03];19:2177068. Available from: https://doi.org/10.1080/216455 15.2023.2177068
Kohler RE, Wagner RB, Careaga K, Vega J, Btoush R, Greene K, et al. Parents’ Intentions, Concerns and Information Needs about COVID-19 Vaccination in New Jersey: A Qualitative Analysis. Vaccines [Internet] 2023 Jun 13; [cited 2024 Jul 03];11(6):1096. Available from: https://www.mdpi. com/2076-393X/11/6/1096
Çelik T, Doğan D. COVID-19 Vaccine Hesitancy of Parents of Children with Type 1 Diabetes in Türkiye: A Mixed-Methods Study. J Pediatr Inf [Internet] 2023 [cited 2024 Jul 03];17(2):e108-e115. Available from: https://doi.org/10.5578/ced.20239805
Shen AK, Browne S, Srivastava T, Michel JJ, Tan ASL, Kornides ML. Factors Influencing Parental and Individual COVID-19 Vaccine Decision Making in a Pediatric Network. Vaccines [Internet] 2022 Aug 8; [cited 2024 Jul 03];10(8):1277. Available from: https://doi.org/10.3390/vaccines10081277
Moore R, Purvis RS, Willis DE, Li J, Langner J, Gurel-Headley M, et al. “Every Time It Comes Time for Another Shot, It’s a Re-Evaluation”: A Qualitative Study of Intent to Receive COVID-19 Boosters among Parents Who Were Hesitant Adopters of the COVID-19 Vaccine. Vaccines [Internet] 2024 Feb 7; [cited 2024 Jul 03];12(2):171. Available from: https://doi.org/10.3390/vaccines12020171
Honcoop A, Roberts JR, Davis B, Pope C, Dawley E, McCulloh RJ, et al. COVID-19 Vaccine Hesitancy Among Parents: A Qualitative Study. Pediatrics [Internet] 2023 Oct 23;[cited 2024 Jul 03];152(5):e2023062466. Available from: https://doi.org/10.1542/peds.2023-062466
Goulding M, Ryan GW, Minkah P, Borg A, Gonzalez M, Medina N, et al. Parental perceptions of the COVID-19 vaccine for 5- to 11-year-old children: Focus group findings from Worcester. Hum Vaccin Immunother [Internet] 2022 Sep 09; [cited 2024 Jul 03];18(6):2120721. Available from: https://doi. org/10.1080/21645515.2022.2120721
Schiff J, Schmidt AR, Pham PK, Pérez JB, Pannaraj PS, Chaudhari PP, et al. Parental attitudes in the pediatric emergency department about the COVID-19 vaccine. Vaccine [Internet] 2022 Out 26; [cited 2024 Jul 03]; 40(7328–7334). Available from: https://doi.org/10.1016/j.vaccine.2022.10.046
Fisher CB, Bragard E, Jaber R, Gray A. COVID-19 Vaccine Hesitancy among Parents of Children under Five Years in the United States. Vaccines (Basel) [Internet] 2022 Ago 14; [cited 2024 Jul 03]; 10(8): 1313. Available from: https://doi.org/10.3390/vaccines10081313
Mitteregger E, Wehrli M, Theiler M, Logoteta J, Nast I, Seliner B, et al. Parental experience of the neuromotor development of children with congenital heart disease: an exploratory qualitative study. BMC Pediatr [Internet] 2021 Out 01; [cited 2024 Jul 03]; 21(1):430. Available from: https://bmcpediatr. biomedcentral.com/articles/10.1186/s12887-021-02808-8
Williams SN, Armitage CJ, Dienes K, Drury J, Tampe T. Public decisions about COVID-19 vaccines: A UK-based qualitative study. PLoS ONE [Internet] 2023 Mar 06; [cited 2024 Jul 03]; 18(3):e0277360. Available from: https://doi.org/10.1371/journal.pone.0277360
Vázquez E, Juturu P, Burroughs M, McMullin J, Cheney AM. Continuum of Trauma: Fear and Mistrust of Institutions in Communities of Color During the COVID-19 Pandemic. Cult Med Psychiatry [Internet] 2023 Set 30; [cited 2024 Jul 03]; 48(2):290–309. Available from: https://link.springer.com/ article/10.1007/s11013-023-09835-3
Chang J, Kochel R. Vaccine Hesitancy and Attributions for Autism among Racially and Ethnically Diverse Groups of Parents of Children with Autism Spectrum Disorder: A Pilot Study. Autism Res [Internet] 2020 Jul 24; [cited 2024 Jul 03]; 13(10):1790–1796. Available from: https://doi.org/10.1002/ aur.2339
Jennings W, Stoker G, Bunting H, Valgarðsson VO, Gaskell J, Devine D, et al. Lack of Trust,Conspiracy Beliefs, and Social Media Use Predict COVID-19 Vaccine. Vaccines (Basel) [Internet] 2021Jun 03; [cited 2024 Jul 03]; 9(6):593. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8226842/
Upenieks L, Ford-Robertson J, Robertson JE. Trust in God and/or Science? Sociodemographic Differences in the Effects of Beliefs in an Engaged God and Mistrust of the COVID-19 Vaccine. J Relig Health [Internet] 2021 Nov 29; [cited 2024 Jul 03]; 61(1):657–686. Available from: https://link.springer. com/article/10.1007/s10943-021-01466-5
Saeed R, Hashmi I. Pakistan Ranks Third Globally With the Most Unvaccinated Children: Is the Impact of Parental Perception and Attitude on Immunization an Essential Contributing Factor to an Unsuccessful Vaccination Coverage? Cureus [Internet] 2021 Nov 19; [cited 2024 Jul 03]; 13(11):e19751. Available from: https://www.cureus.com/articles/24393-pakistan-ranks-third-globally-with-the-most-unvaccinated-children-is-the-impact-of-parental-perception-and-attitude-on-immunization-an-essential-contributing-factor-to-an-unsuccessful-vaccination-coverage#!/
Liao Q, Yuan J, Wong IOL, Ni MY, Cowling BJ, Lam WWT. Motivators and Demotivators for COVID-19 Vaccination Based on Co-Occurrence Networks of Verbal Reasons for Vaccination Acceptance and Resistance: Repetitive Cross-Sectional Surveys and Network Analysis. JMIR Public Health Surveill [Internet] 2024 Abr 22; [cited 2024 Jul 03]; 10:e50958. Available from: https://publichealth.jmir.org/2024/1/e50958
Ige O, Sakas Z, Kang M, Green C, Brown D. Vaccine Confidence in NYC: Thematic Analysis of Community Stories. J Health Commun [Internet] 2023 Jun 30; [cited 2024 Jul 03]; 28(45–53). Available from: https://doi.org/10.1080/10810730.2023.2191226
Muğaloğlu EZ, Kaymaz Z, Mısır ME, Laçin-Şimşek C. Exploring the Role of Trust in Scientists to Explain Health-Related Behaviors in Response to the COVID-19 Pandemic. Sci Educ (Dordr) [Internet] 2022 Fev 05; [cited 2024 Jul 03]; 31(1281-1309). Available from: https://link.springer.com/ article/10.1007/s11191-022-00323-5
Purvis RS, Moore R, Willis DE, Kraleti SS, Gurel-Headley MP, CarlLee S, et al. Key Conversations and Trusted Information Among Hesitant Adopters of the COVID-19 Vaccine. J Health Commun [Internet] 2023 Ago 20; [cited 2024 Jul 03]; 28(09):595–604. Available from: https://doi.org/10.1080/108 10730.2023.2244458
Mathews CJ, McGuire L, Joy A, Law F, Winterbottom M, Rutland A, et al. Assessing adolescents’ critical health literacy: How is trust in government leadership associated with knowledge of COVID-19? PLoS ONE [Internet] 2021 Nov 24; [cited 2024 Jul 03]; 16(11):e0259523. Available from: https:// doi.org/10.1371/journal.pone.0259523
Garg M, Nagrecha AA, Gupta R, Williams M. COVID-19 Vaccine Perspective From Adolescents’ Lens in the US. Cureus [Internet] 2024 Fev 04; [cited 2024 Jul 03]; 16(2):e53566. Available from: https://www.cureus.com/articles/224677-covid-19-vaccine-perspective-from-adolescents-lens-in-the-us#!/
Wang Y, Chen Y. Characterizing discourses about COVID-19 vaccines on Twitter: a topic modeling and sentiment analysis approach. J Commun Healthc [Internet] 2023 Mar 24; [cited 2024 Jul 03]; 16(1):103–12. Available from: https://doi.org/10.1080/17538068.2022.2054196
Lasco G, Yu VG. Communicating COVID-19 vaccines: lessons from the dengue vaccine controversy in the Philippines. BMJ Glob Health [Internet] 2021 Mar 02; [cited 2024 Jul 03]; 6(3):e005422. Available from: https://gh.bmj.com/content/6/3/e005422
Janssen M, Van DVH. Agile and adaptive governance in crisis response: Lessons from the COVID-19 pandemic. Int J Inf Manage [Internet] 2020 Dez; [cited 2024 Jul 03]; 55:102180. Available from: https://doi.org/10.1016/j.ijinfomgt.2020.102180
Bendezu-Quispe G, Benites-Meza JK, Urrunaga-Pastor D, Herrera-Añazco P, Uyen-Cateriano A, Rodriguez-Morales AJ, et al. Consumption of Herbal Supplements or Homeopathic Remedies to Prevent COVID-19 and Intention of Vaccination for COVID-19 in Latin America and the Caribbean. Trop Med Infect Dis [Internet] 2022 Jun 08; [cited 2024 Jul 03; 7(6):95. Available from: https://doi.org/10.3390/tropicalmed7060095
Zieff G, Kerr ZY, Moore JB, Stoner L. Universal Healthcare in the United States of America: A Healthy Debate. Medicina (Kaunas) [Internet] 2020 Out 30; [cited 2024 Jul 03]; 56(11):580. Available from: https://doi.org/10.3390/medicina56110580
Nuwarda R, Ramzan I, Weekes L, Kayser V. Vaccine Hesitancy: Contemporary Issues and Historical Background. Vaccines (Basel) [Internet] 2022 Set 22; [cited 2024 Jul 03]; 10(10):1595. Available from: https://doi.org/10.3390/vaccines10101595
Choi Y, Fox, AM. Mistrust in public health institutions is a stronger predictor of vaccine hesitancy and uptake than Trust in Trump. Soc Sci Med [Internet] 2022 Dez; [cited 2024 Jul 03]; 314:115440. Available from: https://doi.org/10.1016/j.socscimed.2022.115440
Whitehead A, Perry S. How Culture Wars Delay Herd Immunity: Christian Nationalism and Anti-vaccine Attitudes. Socius [Internet] 2020 Dez 07; [cited 2024 Jul 03]; 6(1-12). Available from: https://doi.org/10.1177/2378023120977727
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