Lopa Banerjee
Cardiff University, UK
Title: A systematic review investigating the factors that affect the participation of children and adolescents in vaccine research
Biography
Biography: Lopa Banerjee
Abstract
Introduction: Clinical research requiring participation of children and adolescents, including vaccine research, may be controversial and require greater ethical, legal, and cultural considerations than research involving adults. The aim of this review is to identify the factors (i.e. motivators, barriers, and solutions), which affect the participation (i.e. recruitment and retention) of children and adolescents in vaccine research.
Methods: A systematic review was completed using a search strategy, eligibility criteria, and proforma in a pre-defined protocol submitted to PROSPERO (131360). Papers published up to April 2019, on factors that affect the participation of participants aged 18 years and younger were searched for using seven online databases and hand-searching. Data were extracted using the pre-defined proforma, analysed thematically, and summarised using narrative synthesis.
Results: Of 1216 citations found, 304 full-text articles were reviewed, and 77 papers were included, covering 19 vaccine types from 28 countries. Based on the most frequently occurring reasons, participants and their parents were primarily motivated by their level of understanding, perceived personal benefit, altruism, access to better healthcare, and trust in researchers and healthcare professionals. Barriers included misunderstanding information about the trial, risks of side-effects, mistrust of researchers, conflict between stakeholders (i.e. parents, children and researchers), and fears about trial procedures. Suggested solutions were better education of participants and parents, clear consent and assent processes, and community support.
Conclusion: Many factors that affected participation were identified, with overlap between motivators, barriers and solutions. Literature quantity varied by country and vaccine type, and areas identified for further research were those in which evidence was contradictory or lacking. Utilising age-appropriate consent/assent processes, gaining the support of the entire community, and more effectively delivering information about research and vaccines, both generally, and specifically regarding randomisation, blinding and dispelling therapeutic misconceptions, could improve the participation of children and adolescents in vaccine research.
Keywords – Paediatric Research, Research Participation, Vaccine, Vaccine Research