Exploring vaccine decision-making to identify and address barriers to vaccine uptake in Ireland

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Marshall, Sarah
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University College Cork
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Introduction: Vaccination is one of the greatest public health achievements of the last century. However, vaccine uptake rates worldwide remain sub-optimal. The vaccine decision-making process is complex and multifaceted and multiple barriers to vaccine uptake have already been identified. However, these barriers are highly variable and context specific. Therefore, there is an urgent need to identify and address the factors contributing to decreasing vaccine uptake in Ireland. Aim: The aim of this doctoral research was to explore vaccine decision-making in order to identify, and address, barriers to vaccine uptake in Ireland. Methods: Multiple approaches were used to address this aim. A comprehensive literature review, and subsequent qualitative research, involving parents sought to understand if and how microneedle technology could impact vaccine decision-making and vaccine uptake. In addition, a systematic review and meta-ethnographic synthesis of the qualitative literature and a series of qualitative studies, involving both adolescents and parents, sought to gain an insight into the HPV vaccine decision-making process, to identify barriers to vaccine uptake. This culminated in the development and evaluation of a theory and evidence-based intervention, involving parent-daughter dyads. Results: The vaccine decision-making process was explored qualitatively, in a series of studies, involving multiple stakeholders. Factors such as perception of disease risk, trust in healthcare system, and to a lesser extent, knowledge, interact to impact vaccine decision-making, in the midst of variable, yet omnipresent vaccine safety concerns. Conclusion: This thesis has provided a comprehensive overview of vaccine decision-making and has identified the barriers to vaccine uptake perceived by key stakeholders. These identified barriers may be addressed by policy-makers and vaccinators, to enhance vaccine uptake in Ireland.
Vaccine acceptability , Vaccine hesitancy , Decision-making , Immunisation
Marshall, S. 2020. Exploring vaccine decision-making to identify and address barriers to vaccine uptake in Ireland. PhD Thesis, University College Cork.