Do grandparents influence parents' decision to vaccinate their children? A systematic review

The global reduction in childhood infectious diseases since the 1960s is primarily due to the success of extensive worldwide immunisation campaigns. However, the universal vaccination coverage program appears to have lost momentum in the wake of negative, unfounded claims about the safety of vaccines. While parents of the 21st century have little first-hand knowledge of devastating childhood diseases, grandparents are more likely to remember family and community members who were afflicted. In the current age of vaccine hesitancy and science scepticism, where research-informed arguments are not always persuasive, grandparents, through their experience of the diseases, may positively influence paediatric vaccine uptake. This paper reviews the literature investigating potential direct or indirect influences of grandparents on parents' decisions to vaccinate their children. A database search using the keywords immunisation, vaccination, children and grandparents resulted in 1988 articles. Titles were screened for relevance and seventy-seven results were retained. After the abstracts were read, only five articles that either explored paediatric vaccines, factors promoting and/or inhibiting paediatric vaccine use and decision-making strategies were reviewed. One paper located through Google Scholar, which failed to show up on database searches, was also retained for a total of six papers. While none of the six papers set out to explore the impact of grandparents on vaccine uptake, they found that grandparents were involved to varying degrees in paediatric vaccine uptake within young families. The research clearly showing that grandparents, and older people more generally, promote vaccination uptake is not currently available. The dearth of literature shows the need for research exploring the perceived and real influences of grandparents on childhood vaccination. This will establish whether grandparents' memory and knowledge of preventable childhood infectious diseases could be harnessed as a public health measure to counteract the current, ill-informed, negative attention on paediatric vaccines.