Studying anti-vaccination behavior and attitudes: A systematic review of methods

Abstract

Immunization is one of the most significant achievements of public health over the last 100 years. Recently, however, people have been increasingly refusing to vaccinate. There are a large number of separate studies on how pervasive this behavior is and what fac- tors influence it, but no systematic review has been undertaken so far that looked at these studies as a whole. To conduct an analysis of studies that examine vaccine refusal and negative attitudes towards vaccination, focusing on the methodological approaches to the study of these problems and evaluation of their quality. A systematic review of English-language studies published between 1980 and 2015, using the Web of ScienceTM Core Collection database. The final review dealt with 31 papers. The studies in question were mainly conducted in North America and Western Europe. They were published three years after conclusion, on average. We have identified five different approaches to the study of these problems: 1) studies of parents’ attitudes and behavior; 2) analysis of vaccination records; 3) studies of attitudes and behavior among the general population; 4) studies of medical professionals’ attitudes, behavior, and experience; and 5) others. We found that theoretical models were not commonly used at the planning stage, while the studies also lacked a common approach to the operationalization of vaccine refusal, as well as of negative attitudes towards vaccination. Several promising directions have been identified for future studies on vaccine refusal and negative attitudes towards vac- cination.

Keywords

• vaccination
• vaccine refusal
• attitudes towards vaccination
• systematic review