Parental perceptions of chickenpox and the varicella vaccine: A qualitative systematic review

Zoe Jordan*, Emma Rehman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: In countries where varicella vaccination is not on the routine childhood immunisation schedule, such as those in the United Kingdom (UK), chickenpox is an almost universal disease of childhood. Chickenpox
can cause serious complications, particularly in infants, pregnant women, and the immunocompromised. In November 2023 the varicella vaccine was recommended for inclusion in the UK routine childhood immunisation schedule. Successful rollout of the vaccine may be hindered by parental concerns about vaccine safety and efficacy, and perceptions of chickenpox as a mild illness.
Objective: To examine parental perceptions of chickenpox and varicella vaccination, which may be crucial to effective vaccination campaigns.
Design: Qualitative systematic review and thematic analysis.
Methods: Six electronic databases were systematically searched for studies published between 2016 and 2023:
CINAHL, EMBASE, MEDLINE, PsycInfo, PubMed, and Web of Science. The included studies were appraised against the Critical Appraisal Skills Program checklist for qualitative studies. Thematic analysis was used to analyse qualitative data, through the development of themes.
Results: 22 articles were included in this review, and five themes identified: perceptions that chickenpox is a mild illness, that parents have concerns about varicella vaccine efficacy and safety, a notion of natural immunity as
superior, social determinants of health influence vaccine decision making, and vaccination is overwhelming perceived as a parental decision.
Conclusions: Whilst some parents displayed an acceptance and willingness to vaccinate against chickenpox, many expressed concerns, and perceived chickenpox as a routine unworrying childhood illness. Analysis demonstrated
a knowledge gap in understanding UK parental opinions regarding chickenpox and varicella vaccination, highlighting the need for research in this area, particularly given ongoing reconsideration for inclusion in the UK
vaccination schedule.
Original languageEnglish
Pages (from-to)75-83
Number of pages9
Issue number2
Early online date28 Dec 2023
Publication statusPublished - 12 Jan 2024


  • Chickenpox
  • Chickenpox vaccine
  • Parents
  • Vaccination
  • Vaccination hesitancy


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