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A systematic review on factors influencing immunisation adherence among children under 12 years of age

Bridgette Lockett1, Juliana J Willemse1, Rugira M Modeste2

  • 1School of Nursing, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa.

Health SA = SA Gesondheid
|September 12, 2025
PubMed

Insights

Improving childhood immunisation adherence requires addressing socioeconomic, health system, belief, cultural, and communication factors. Tailored strategies and digital tools are key to enhancing vaccine coverage and public health.

Area of Science:

  • Public Health
  • Epidemiology
  • Health Policy

Background:

  • Immunisation is vital for preventing infectious disease spread.
  • Childhood vaccination adherence faces global challenges, impacting public health.
  • Understanding adherence factors is crucial for improving vaccine coverage.

Purpose of the Study:

  • To develop a support intervention for improving childhood immunisation adherence in South Africa.
  • To identify key factors influencing vaccination adherence in children under 12.

Main Methods:

  • Systematic review following PRISMA guidelines (2013-2023).
  • PICO framework used for research question and search strategy.
  • Data extraction and categorization into influencing domains; quality assessment via MM Tool.

Main Results:

  • Five major domains identified: socioeconomic, health system, vaccine beliefs/attitudes, cultural/social, and communication/information.
  • These domains collectively influence childhood immunisation adherence.
  • Intervention areas include communication, vaccine hesitancy, accessibility, and digital promotion.

Conclusions:

  • Childhood vaccination adherence is influenced by a complex interplay of factors.
  • Tailored communication, addressing hesitancy, and improving accessibility are critical.
  • Leveraging digital technologies can enhance vaccine promotion and adherence.
Abstract

Keywords:
adherencechildrenhealth systemsimmunisationsocioeconomic factorsvaccine hesitancy

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