Judy Gichuki

and 3 more

Abstract Background: There has been a decline in childhood vaccination uptake, with reports indicating that 25 million children missed out on one or more doses in 2021 . There is a need to understand the socio-behavioural drivers of vaccination uptake and to identify contextual and emerging factors that can inform demand-creation interventions. Objective: This review examined the social and behavioural factors influencing childhood vaccination intentions and uptake globally. Methods: A comprehensive search was carried out for published studies that presented data on patterns of association between socio-behavioural factors and vaccination intentions and uptake in children under five years. Studies were screened for eligibility by two reviewers, and information was collected using a standard data abstraction form. Findings: Out of 4462 records identified in the search, 82 studies were included. Emerging factors influencing vaccination uptake included gender-based factors like the mother’s financial autonomy, the number of social and formal messengers recommending vaccination, the proportion of non-conforming social network members, and the role of decisional balance and conflict as a moderator of the vaccination intention and action pathway. Conclusion: The review identified multiple behavioural and social constructs influencing vaccination intentions and uptake. The diversity of influences underscores the complexity of relationships between social-behavioural factors and vaccination uptake, which may be contributing to low vaccination uptake. More context-specific research is required to extend the geographical base and depth of evidence and to evaluate highly localised socio-behavioural interventions.