Vaccine hesitancy among parents of preschoolers in Canada: a systematic literature review.

Objectives: The purpose was to synthesize the available literature on what factors influence vaccine hesitancy of parents of preschoolers in Canada.

Methods: Databases (e.g., CINAHL, PubMed, OVID, Proquest) were searched for relevant research articles produced between January 2009 and October 2019. Articles were required to examine vaccine uptake in children aged 0-7, in the English language, and focused within a Canadian context. Articles were excluded if they focused on uptake of the influenza vaccine and if the study population was children with chronic health conditions. A total of 367 articles were reviewed and 12 met the criteria for inclusion in this review.

Synthesis: This review found that between 50% and 70% of children are completely vaccinated at 2 years old, with up to 97% having received at least one vaccine, and 2-5% receiving no vaccines. This review found that trust and access to health care providers is significantly associated with vaccine uptake, likely more important than parents' vaccine knowledge, and may compensate for challenges related to socio-economic status and family dynamics.

Conclusion: Vaccine programs need to be created that are accessible to all families, with an awareness of the significant impact of trust on vaccine uptake. Future research should include consistent measures of vaccine uptake, and data from First Nation communities, and should examine how increased trust between health care providers and parents of preschool children would increase vaccine uptake in Canada.