Determinants of vaccine hesitancy towards pediatric and adolescent vaccinations and interventions aimed at contrasting that issue in Europe: an overview of systematic reviews
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Department of Public Health Sciences, University of Turin, Turin, Italy
Department of Human, Social and Health Sciences, University of Cassino and Southern Lazio, Cassino, Italy
Department of Public Health Sciences, University of Turin
A.O.U. City of Health and Science of Turin, Italy
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A1994
Background and Objective: Vaccine hesitancy represents a relevant threat to global health. Specifically, vaccine hesitancy has shown an increase in the last two decades in Europe. The present overview aimed to describe determinants of vaccine hesitancy and interventions to reduce vaccine hesitancy or increase vaccine uptake among children and adolescents in Europe. Methods: We developed a comprehensive search strategy to find the latest existing systematic reviews on the following databases: PubMed, Embase, and Epistemonikos, including only papers published in 2017 or after. The search was performed in 2022. Only papers about determinants or interventions addressed to parents, children, or adolescents were considered eligible. Each article was screened at least by two authors, blinded to each other’s decisions. This overview has been conducted within the project “VAX-TRUST, addressing vaccine hesitancy in Europe” (This project has received funding from European Union’s Horizon 2020 research and innovation program under Grant Agreement No. 965280). Results: A total of 3363 records were screened. The final set of selected papers consisted of 28 systematic reviews. We examined the overlap of the systematic reviews within the overview using the CCA index obtaining the value of 1.39%, thus suggesting a low overlap. A total of 232 European primary studies contained in the systematic reviews were identified (212 observational studies and 20 experimental studies, including 15 RCTs and 5 quasi-experimental studies). Preliminary analyses showed that safety and trust concerns were the most frequently reported hesitancy determinants and the implementation of school programs involving nurses and general practitioners was the most frequently reported effective intervention. Conclusions: This overview mainly highlighted issues in trust and safety concerns and suggested that school programs can be effective in the European context. It is essential to continue to study the reasons for vaccination hesitancy and to search for methods to decrease the phenomenon.