Vaccination is one of the most cost-effective and successful public health interventions to prevent infectious diseases. Governments worldwide have tried to optimize vaccination coverage, including using vaccine mandates. This review of recent literature and policy aims to provide a comprehensive overview of Malaysia’s childhood vaccination landscape. The document analysis was used to identify and examine information from government policy documents, official government media statements, mainstream news content, and research papers. Content analysis was then employed to analyze the gathered information. Despite the successes of Malaysia’s National Immunization Programme, a resurgence of vaccine-preventable diseases has raised concerns about vaccine hesitancy and refusal. Several contributing factors have been identified, including a preference for alternative medicines, doubts about halal status, fear of vaccine injury, concerns about the vaccines’ contents, conspiracy theories, as well as convenience and access barriers. While various initiatives have been implemented, Malaysia may consider using vaccine mandates, as several countries have recently done, as a potential policy intervention to address these challenges. This review benefits policymakers, epidemiologists, as well as researchers involved in regional or global policy planning and advocacy efforts. It also offers comprehensive insights into designing effective interventions and making informed policy decisions regarding childhood vaccination programmes.