The Effect of Interventions on the Prevention of Parental Vaccine Refusal and Hesitancy: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Vaccination is an effective way to prevent infectious diseases. However, parental resistance to childhood immunizations has recently been a growing trend due to various factors. This systematic review and meta-analysis study focused on randomized controlled trials to investigate interventions for preventing parental vaccine refusal/hesitancy. This study was conducted according to the preferred reporting items for systematic review and Meta-analysis Protocols. PubMed, Science Direct, Web of Science, MEDLINE, Cochrane Library, Ovid, CINAHL, and ProQuest databases were screened with no year restriction. Two researchers each used the Cochrane risk-of-bias tool to determine the quality of the trials. Data were synthesized using a meta-analysis package. The study population consisted of 3,302 articles. The sample consisted of 22 randomized controlled trials, which implemented the interventions of text message reminders, digital training in vaccination, training in physician communication, training in parental decisionmaking, web-based activities, perinatal training in vaccination, immunization reminder and follow-up bracelets, and mother-daughter training. The results showed that slightly more parents agreed to get their children vaccinated after the interventions. The trials were moderately heterogeneous due to differences in sample size, country, and year. This paper investigated the effect of interventions on parental vaccine refusal/hesitancy and provided level-A evidence to suggest such interventions can be used to change parents’ vaccination comprehension and decisions.