Journal of Clinical and Cellular Immunology
Open Access
ISSN: 2155-9899
ISSN: 2155-9899
Lopa Banerjee, Nina Gobat, Alyssa Ralph and Micaela Gal
Cardiff University, UK
Cardiff University School of Medicine, UK
London School of Hygiene and Tropical Medicine, UK
Scientific Tracks Abstracts: J Clin Cell Immunol
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 predefined
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 handsearching.
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.
Lopa Banerjee is currently a 22-year-old fourth year medical student at Cardiff University School of Medicine. In 2018, she completed an intercalated BSc in Clinical Epidemiology at Cardiff University, achieving first class honours and being awarded the ‘Deans List Award’. She has been involved with a range of research projects at university including studies on sepsis and Human Immunodeficiency Virus (HIV). She has also been President of Cardiff Students for Global Health, the global health society at Cardiff University and was a Co-Chair for the Organising Committee for the Students for Global Health National Conference on Sexual Health and HIV in 2018, which involved being the lead organiser for a 2 day national student conference.
E-mail: BanerjeeL@cardiff.ac.uk