Abstract
Introduction: Chickenpox (varicella) contributes to a large number of hospitalisations in the United Kingdom (UK)
where vaccination is not routine, and can result in serious complications. The varicella vaccine was recommended for inclusion in the UK routine immunisation schedule by the Joint Committee on Vaccination and
Immunisation (JCVI) in November 2023. A systematic review identified no previous qualitative studies investigating UK parents’ views regarding chickenpox and vaccination.
Objective: To explore parents’ views of chickenpox and varicella vaccination, and identify barriers and facilitators
to this and other childhood vaccinations.
Methods: Underpinned by sequential mixed-methodology a quantitative cross-sectional online survey (n = 609),
distributed via nurseries and social media, and qualitative semi-structured interviews (n = 12) with a sub-sample
of survey respondents. Descriptive statistical analysis was undertaken on quantitative data. Qualitative data were
interpreted by reflexive thematic analysis, according to the EQUATOR network standards for reporting qualitative research. Findings were analysed separately, and integrated equally using a triangulation protocol for
validation or repudiation.
Findings: Integration demonstrated parents perceived chickenpox as a common, typically mild, childhood illness.
Parents held few concerns, with most worries focussing on severe infection risk, and impact on time off school or
work. Most would accept routine varicella vaccination, though had concerns about duration of immunity. Many
questioned necessity of vaccination, and whether natural immunity was superior. Non-vaccinating parents hold
distinct concerns relating to safety, vaccine contents, and their synthetic nature.
Discussion and Conclusion: Whilst most parents are accepting of vaccination, they hold specific concerns related to
varicella vaccination which may result in sub-optimal uptake for critical herd immunity. To achieve this it will be
crucial to raise awareness of the potential risks of chickenpox, and address concerns identified. Many parents
seek reliable vaccine information from healthcare professionals, and so appropriate education and training
should be considered, including communicating risks and benefits of vaccination, which may be beneficial
antenatally.
where vaccination is not routine, and can result in serious complications. The varicella vaccine was recommended for inclusion in the UK routine immunisation schedule by the Joint Committee on Vaccination and
Immunisation (JCVI) in November 2023. A systematic review identified no previous qualitative studies investigating UK parents’ views regarding chickenpox and vaccination.
Objective: To explore parents’ views of chickenpox and varicella vaccination, and identify barriers and facilitators
to this and other childhood vaccinations.
Methods: Underpinned by sequential mixed-methodology a quantitative cross-sectional online survey (n = 609),
distributed via nurseries and social media, and qualitative semi-structured interviews (n = 12) with a sub-sample
of survey respondents. Descriptive statistical analysis was undertaken on quantitative data. Qualitative data were
interpreted by reflexive thematic analysis, according to the EQUATOR network standards for reporting qualitative research. Findings were analysed separately, and integrated equally using a triangulation protocol for
validation or repudiation.
Findings: Integration demonstrated parents perceived chickenpox as a common, typically mild, childhood illness.
Parents held few concerns, with most worries focussing on severe infection risk, and impact on time off school or
work. Most would accept routine varicella vaccination, though had concerns about duration of immunity. Many
questioned necessity of vaccination, and whether natural immunity was superior. Non-vaccinating parents hold
distinct concerns relating to safety, vaccine contents, and their synthetic nature.
Discussion and Conclusion: Whilst most parents are accepting of vaccination, they hold specific concerns related to
varicella vaccination which may result in sub-optimal uptake for critical herd immunity. To achieve this it will be
crucial to raise awareness of the potential risks of chickenpox, and address concerns identified. Many parents
seek reliable vaccine information from healthcare professionals, and so appropriate education and training
should be considered, including communicating risks and benefits of vaccination, which may be beneficial
antenatally.
| Original language | English |
|---|---|
| Article number | 127322 |
| Pages (from-to) | 1-12 |
| Number of pages | 12 |
| Journal | Vaccine |
| Volume | 61 |
| DOIs | |
| Publication status | Published - 11 Jun 2025 |
Keywords
- Chickenpox
- chickenpox vaccine
- child
- immuninsation
- parents
- public health
- vaccination
- vaccine hesitancy