Impact of COVID-19 on Parental Barriers to Childhood Vaccination: A Systematic Review

Introduction This systematic review examined how the COVID-19 pandemic influenced parental barriers to routine childhood vaccination in the United States, with attention to changes in vaccine access, concern, and perceived importance. Methods Guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses, we searched PubMed, CINAHL, PsycINFO, Scopus, and Web of Science for United States-based studies published January 2015 through May 2024. Eligible studies were conducted before March 2020 (prepandemic) or after (pandemic era). Two reviewers independently screened, extracted data, and assessed quality using the Mixed Methods Appraisal Tool. Results Of 4,813 records screened, 21 met inclusion criteria (14 prepandemic, seven pandemic era). Access barriers, especially among low-income, immigrant, and underrepresented racial/ethnic groups, persisted across timeframes. Pandemic-era studies reported heightened parental anxiety, misinformation, and reduced prioritization of vaccination. Conclusions The pandemic intensified existing barriers. Public health strategies should address misinformation, rebuild trust, and reduce structural inequities to improve postpandemic childhood vaccination coverage. Copyright © 2025 National Association of Pediatric Nurse Practitioners.