An integrative review of adolescent voice on vaccination.

PROBLEM: Adolescents are a critical population for immunization efforts, yet their voice in vaccination decisions remains underrepresented. Vaccine decision-making during adolescence is frequently parent-driven, limiting adolescent engagement and agency.

ELIGIBILITY: Studies were included if they examined adolescent perspectives on vaccination, involved participants aged 10-19 years, and addressed vaccines on the WHO-recommended immunization schedule. Quantitative, qualitative, and mixed-methods peer-reviewed studies were eligible. Studies without direct adolescent voice were excluded.

METHODS

This integrative review was conducted using PRISMA methodology. A comprehensive search of global databases identified studies including adolescent vaccination attitudes and decision-making. After screening, 93 studies met inclusion criteria. Data were extracted and synthesized using thematic analysis.

RESULTS

Five themes emerged: concepts of Health Belief Model, knowledge deficits, influence of parents, peers, and healthcare providers, vaccine-related concerns, and limited adolescent autonomy in vaccine decisions. The human papillomavirus (HPV) vaccine was frequently examined, with adolescents associating it with sexuality, stigma, and misinformation. Adolescents identified healthcare providers as trusted sources; however, parents continued to control vaccination decisions. Barriers such as fear of needles, concerns about side effects, and access challenges were reported.

CONCLUSIONS

Adolescent voice remains insufficiently represented in vaccination research. This highlights knowledge gaps, barriers, and constrained autonomy influencing vaccination attitudes and behaviors.

IMPLICATIONS: The study emphasizes the need for adolescent-centered education, improved access, and inclusive decision-making practices. By spotlighting adolescent voices, this review contributes to strategies for increasing vaccine uptake and addressing vaccine hesitancy in a population crucial to public health.