: Vaccine refusal is increasing in Australia and is a major concern in high- and middle-income countries. There is evidence to suggest that some parents, even those who elect to immunise, may be vaccine hesitant with some manipulating the schedule by excluding or delaying some vaccines. The aim of this review was to gain an understanding of factors that influence vaccine decision-making in pregnant women and parents of children. : An integrative review approach was used to produce an analysis of existing literature on vaccine decision-making in pregnancy and parents. As the broadest of review methods, an integrative review can include a range of experimental and non-experimental research, thereby ensuring the inclusion of data from multiple perspectives. : Online databases were searched for research related to vaccine decision-making in pregnant women and parents. Original and review articles were sought that were published in English between 2015 and 2021. Reviewed articles included qualitative and quantitative studies and systematic reviews. No mixed methods papers were located or excluded from this review. : The review method was an integrative review informed by Coughlan. : Papers from thirteen predominantly high- and middle-income countries were selected for this review. A total of 31 articles fit the inclusion/exclusion criteria, including qualitative, quantitative and review articles. Three main themes were identified including the role of healthcare professionals, vaccine safety concerns and alternative influences. Alternative influences included: social media, friends and family, religion, conspiracy theories and salutogenic parenting. Findings suggest that high levels of anxiety are involved in vaccine decision-making with parents seeking information from multiple sources including healthcare professionals, friends and family and social media. : Pregnancy is an ideal time to provide education on both pregnancy and childhood vaccinations. However, some parents reported dissatisfaction in their therapeutic relationships with healthcare professionals. As a result, parents can resort to their own information seeking, in the main via social media which has been linked to vaccine refusal. Additionally, some healthcare professionals report feeling inadequately prepared for the role of immunisation promotion and provision. Parental information seeking from non-traditional sources has been shown to result in the acquisition of misinformation, exposure to conspiracy theories, the inevitable loss of vaccine confidence and subsequent vaccine refusal.

Aim: The aim of this paper is to critically reflect on our team's experience of using netnography to explore vaccine‐hesitant parents and pregnant women, a group who have traditionally been difficult to recruit to research studies and a methodology that is underutilized in nursing research.Design: This paper takes the form of a discussion paper that will utilize data obtained from a qualitative netnographic study. Relevant literature was searched including 2015–2023.Method: This paper utilized data obtained from a qualitative study that used netnography as methodology and an online minable data source. Netnography is a relatively new methodology that uses the online environment to explore digital cultures and study networked society. It pays particular attention to cultural insights and conditions that impact the human experience. This methodology is particularly relevant to nursing research which is often humanistic and always conducted to ensure optimal patient outcomes.Results: Using netnography for the first time has resulted in four main insights. These include the adaptability of the process; the creativity involved in designing the site; the ready acceptance of the site by participants and the co‐creation knowledge that resulted.Conclusions: Netnography is a creative methodology that was successful in accessing and engaging the vaccine‐hesitant community, a group who are often marginalized. Netnography has the advantage of using a platform that is familiar and safe for many people and provides access to an extensive minable data source.

Background: Immunization is one of the most significant health initiatives of recent times. Despite this, vaccine hesitancy is increasing and was listed as one of the top 10 threats to global health by the World Health Organization in 2019. A major factor associated with vaccine hesitancy is thought to be the viral spread of misinformation by a small but active anti-vaccination movement. Objectives: The purpose of this study was to explore the influences of social media on vaccine decision-making in parents. Design: This study is part of a larger body of research that explored vaccine decision-making in parents. Other methods included were an online survey and semi-structured interviews. This study investigated the influence of cyberculture on parents in an online environment. Method: This study employed netnography, a form of qualitative inquiry with its roots in ethnography as methodology and a purpose-designed Facebook page as the means of exploring a purpose-designed online community with a particular focus on the culture, belief systems and influences present. Both manual and computer-assisted thematic analyses were used to analyse the data obtained. Results: Three key themes were identified in this study. These included vaccine safety concerns, the emotional debate and COVID-19-specific issues. The results indicated the presence of strong anti-vaccination sentiment combined with an ‘infodemic’ of conspiracy theories, misinformation and vitriol with the potential to negatively impact parents seeking immunization information. Conclusion: Given the popularity and accessibility of social media and the ready access to misinformation present online, it is evident that parental vaccine decision-making may be impacted adversely. Therefore, it is important that healthcare professionals are aware of this and provide adequate and timely education prior to parents seeking information on social media.

Research involving Indigenous communities has been traditionally dominated by Western methodologies which may not fully capture Indigenous perspectives, often marginalising Indigenous knowledge systems and voices. Employing Indigenous data analysis methods supports decolonising interpretation of research data and supports a decolonised approach. This review aimed to identify what Indigenous research data analysis methods exist. Searches were conducted on Medline (via Ovid SP), PsycINFO (via Ovid SP), Web of Science (Clarivate Analytics ) , Scopus (Elsevier), Cumulated Index to Nursing and Allied Health Literature CINAHL (EBSCOhost), ProQuest Central, ProQuest Social Sciences Premium (Clarivate). ProQuest (Theses and Dissertations) were searched for unpublished material. This review identified 17 studies that integrated four Indigenous data Analysis methods: The Kaupapa Māori framework, Yarning method, Talking Circles and NAKPA method (Cree words meaning Medicine/Healing Stories, picked, sorted and stored). A further method “Thought Ritual” is discussed but remains untested in primary research hence was not included in this review. While decolonising research methodologies are growing in use, there is a significant gap in Indigenous data analysis methods.