INTRODUCTION:
Malaria is a major cause of morbidity and mortality in sub-Saharan Africa in children under five years of age. Recent vaccine actions, i.e., RTS,S/AS01E and R21/Matrix-M are a breakthrough in prevention. However, success is not only dependent on the efficacy on the part of science, but also on the trust of the caregivers to vaccinate and to report the adverse events in a transparent manner.

METHODS:
This study covered peer reviewed and grey literature between 2016-2025. We performed systematic searches of various databases with keyword and Boolean operators. Of 6,861 records, according to inclusion criteria, 29 were included. Data extraction was aimed at vaccine acceptance and adverse events reported and the factors influencing the opinion in caregivers. A thematic synthesis and critical appraisal ensured quality and relevance of methodology.

RESULTS:
Findings showed that caregivers tend to be willing to vaccinate, acceptance rates vary between 62 – 95%. Urban caregivers are more likely to accept vaccination as compared to rural caregivers, due to better access to health information and stronger ties to health workers. Most of the adverse events that were reported were mild: fever, pain at the injection site, and short-term loss of weight. Nonetheless, vaccine hesitancy was still a problem which was often provoked by misinformation, cultural beliefs and household decision making as well as a lack of knowledge about vaccine safety. Several caregivers were affected by social networks and community leaders and acceptance by health professionals became a significant driving force.

CONCLUSIONS:
In conclusion, malaria vaccination has a good acceptance and safety profile but socio - cultural and information barriers still impact on the decision - making of caregivers. Culturally sensitive approaches, open adverse event monitoring and trustworthy ways of interacting with communities at the community level are required in order to maximize uptake.