A Systematic Review of Parents’ Perceptions About Childhood Vaccine Safety and Efficacy Among Multicultural Communities in Australia and New Zealand

Background Immunization programs are the most cost-effective public health intervention for preventing and controlling communicable diseases at individual and community levels. High herd immunity can be achieved by implementing routine childhood vaccination programs, leading to fewer outbreaks and reduced mortality and morbidity from vaccine-preventable diseases worldwide. The responsibility for vaccinating children on time and fully predominantly lies with parents; howeve, parents’ perceptions regarding vaccine safety and efficacy greatly influence immunization rates. This systematic review was conducted to better understand parental perceptions of childhood vaccine safety and efficacy, and the factors influencing their perceptions.Purpose To critically evaluate the scientific literature for the purpose of identifying multicultural parents’ perceptions regarding childhood vaccine safety and efficacy. This paper also aims to identify the cultural, demographic and socioeconomic factors that shape parents’ views.Methods A comprehensive systematic search, following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, was conducted on CINAHL, BioMed Central, PubMed, Medline, and other databases to identify relevant publications on parents’ perceptions, published from 2015 to 2025. Findings were synthesized to assess parents’ perceptions about childhood vaccine safety and efficacy.Results A total of 18 studies met the inclusion criteria, all having cross-sectional designs, of which 13 are quantitative and 5 are mixed methods. Parental vaccine perceptions are associated with different determinants such as cultural beliefs, sources of information, socioeconomic and demographic factors, and access to healthcare facilities.Discussion The findings show that parental perceptions of vaccination are varied and influenced by safety and efficacy factors, sources of information, trust, socioeconomic circumstances, cultural and linguistic backgrounds, and access to healthcare services. There were differences in levels of concern and confidence among different ethnic groups, such as Indigenous, migrant, refugee, and non-English-speaking. These results suggest that in order to promote confidence in immunization programs, culturally competent communication, community engagement, and support systems are needed to enhance confidence in immunization programs.Translation to Health Education Practice Parents from multicultural communities often have limited access to clear health information, language barriers, and concerns about vaccine safety and adverse effects, which directly influence childhood immunization decisions. Health Education Practice should therefore focus on culturally tailored communication, build trust in healthcare providers, and provide simple, accurate, and accessible vaccine information to inform parental decision-making.