Vaccine uptake remains one of the most critical determinants of population health, yet it is persistently undermined by inequalities in healthcare access, sociopolitical dynamics, and varying degrees of trust in health systems. Drawing exclusively on an extensive body of existing scholarship, this article provides a theoretically rich and empirically grounded analysis of vaccine hesitancy and access disparities across ethnic, migrant, and socioeconomically diverse populations. The study integrates perspectives from health economics, social epidemiology, political science, and ethics to examine how structural inequalities, historical marginalisation, political ideology, misinformation, and institutional trust interact to shape vaccination behaviours. Particular attention is paid to childhood and COVID-19 vaccination contexts, highlighting how parental attitudes, maternal knowledge, racialised experiences, and policy frameworks converge to influence outcomes. Methodologically, the article synthesises insights from population-based surveys, systematic reviews, qualitative studies, and policy analyses contained within the reference corpus. Findings reveal that vaccine hesitancy is neither monolithic nor reducible to individual knowledge deficits; rather, it is embedded in broader systems of inequality, governance, and social meaning. The discussion situates these findings within contemporary debates on health equity, research integrity, and culturally responsive public health strategies. The article concludes by arguing for a multidimensional approach to improving vaccine uptake that simultaneously addresses access barriers, rebuilds trust, counters politicisation, and strengthens community-centred engagement. By offering an integrative theoretical framework grounded strictly in the referenced literature, this study contributes to advancing scholarly understanding and informing equitable vaccination policy in increasingly diverse societies.

Vaccine hesitancy, healthcare inequality, trust in health systems

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