Date of Award

2026

Type

Thesis

Major

Health Science

Degree Type

Master of Public Health

Department

Kinesiology and Health Sciences

First Advisor

Dr. Patricia Anafi

Second Advisor

Dr. Rebecca Toland

Abstract

Routine childhood and adolescent vaccination is an essential public health strategy for preventing disease and protecting communities. However, parental vaccine hesitancy and barriers to vaccine uptake continue to affect vaccination decisions in the United States. This scoping review examined factors associated with routine childhood and adolescent vaccine hesitancy and uptake among U.S. parents. A comprehensive literature search of PubMed and EBSCO identified peer-reviewed studies published in English between 2016 and 2026. Studies focusing on parents, guardians, or caregivers of children and adolescents in the United States were screened according to predefined eligibility criteria. Of 69 records identified, 52 remained after 17 duplicates were removed; 31 full-text articles were assessed, and 23 studies were included in the final review. Findings were organized using the Social Ecological Model. Interconnected individual, interpersonal, and structural factors, including concerns about vaccine safety and side effects, misinformation, mistrust of healthcare and government institutions, perceived low disease risk, health literacy, social influences, healthcare provider communication, socioeconomic conditions, and barriers to healthcare access, shaped parental vaccination decisions. Hesitancy varied by vaccine type, with greater reluctance reported for COVID-19, influenza, and human papillomavirus vaccines than for traditional routine childhood vaccines. Strategies associated with improved vaccine acceptance and uptake included strong healthcare provider recommendations, targeted education and communication, reminder and recall systems, improved accessibility, digital outreach, and supportive vaccination policies. These findings suggest that parental vaccine hesitancy is a complex, multilevel public health issue requiring interventions that strengthen trust, communication, healthcare access, and supportive systems.

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