A systematic review on parental vaccine hesitancy for childhood immunizations in the European region: Can findings be generalized?

Vaccine hesitancy (VH) for childhood immunizations has been widely studied, but no review has synthesized evidence across Europe. This review addresses that gap using both qualitative and quantitative perspectives. A systematic search on February 5th, 2025, was conducted in MEDLINE/PubMed and Web of Science to assess the generalizability of findings regarding parental VH regarding childhood vaccinations (excluding HPV and Influenza) across the WHO European Regions. Forty-nine articles published between January 2015 and December 2024 in English, Dutch or French were included. Using WHO's 3C model (confidence, convenience, complacency), trust in healthcare professionals (HCPs) emerged as a key factor, while fear of side effects, logistical barriers and low perceived disease risk negatively influenced decisions. Demographic determinants were not generalizable across countries due to methodological and contextual (cultural, socioeconomic and healthcare system) differences, reinforcing the need for tailored approaches. VH remains multidimensional and context-dependent. WHO's 3C model is a useful tool for understanding VH. Tailored, country-specific strategies are needed, with strong HCP - caregiver relationships and policies addressing practical and socioeconomic barriers to ensure equitable access to childhood vaccination.