Barriers and facilitators associated with migrant parents' decisions regarding childhood vaccinations: A mixed methods systematic review.

Introduction: Migration presents complex challenges for global public health. Pathogens do not recognise borders, and despite the success of vaccination in reducing infant and child mortality, significant gaps in coverage between migrants and host populations exist. Immigrant or migrant children are most at risk of severe health outcomes due to under- or non-vaccination. Although multiple factors contribute to low vaccination uptake, research has identified factors linked to parental attitudes towards vaccination. These factors are crucial in influencing children's vaccination against preventable diseases.

Aim: The aim of this review is to synthesise and integrate the evidence on the barriers and facilitators associated with migrant parents' decisions to vaccinate their children.

Methods: This review followed the Joanna Briggs Institute methodology for MMSR using a convergent integrated approach. The population, phenomenon of interest, and context (PICo) was applied to formulate the review question. The following databases were systematically searched; MEDLINE Ovid (1946-2024), EMBASE Ovid (1974-2024), Cinahl EBSCO Host (1937-2024), PsycINFO (Ovid), Web of Science and Scopus.

Results: Twenty studies were included, with four themes emerging. 'Health literacy' highlights how language proficiency and knowledge either help or hinder migrant parents' ability to understand, access, and navigate healthcare systems; 'trust in care' refers to their confidence in health and social care professionals and the system delivering childhood vaccinations; 'access' represents the ease or difficulty they face in reaching and using vaccination services; and 'fear and perception' relate to how trust, perceived susceptibility, and the attitudes of family and social networks influence their vaccination decisions.

Conclusion: Vaccination equity is critical for safeguarding migrant and host populations. Addressing this disparity reduces outbreak risks and ensures global health security. The development of culturally and linguistically appropriate vaccination campaigns is needed to educate migrant parents on vaccination benefits and accessibility.