Changes in Parents’ COVID-19 Vaccine Hesitancy for Children Aged 3–17 Years before and after the Rollout of the National Childhood COVID-19 Vaccination Program in China: Repeated Cross-Sectional Surveys

Abstract

China started to implement COVID-19 vaccination programs for children in July 2021. This study investigated the changes in parents’ COVID-19 vaccine hesitancy for children before and after the vaccination program rollout. Repeated cross-sectional online surveys among full-time adult factory workers were conducted in Shenzhen, China. This analysis was based on 844 (first round) and 1213 parents (second round) who had at least one child aged 3–17 years. The prevalence of vaccine hesitancy for children aged 3–11 years dropped from 25.9% (first round) to 17.4% (second round), while such a prevalence for children aged 12–17 years dropped from 26.0% (first round) to 3.5% (second round) (p < 0.001). Positive attitudes, a perceived subjective norm, and perceived behavioral control related to children’s COVID-19 vaccination were associated with lower vaccine hesitancy in both rounds. In the second round and among parents with children aged 3–11 years, negative attitudes and exposure to information on SARS-CoV-2 infection after receiving a primary vaccine series were associated with higher vaccine hesitancy, while exposure to experiences shared by vaccine recipients and infectiousness of variants of concern were associated with lower vaccine hesitancy. Regular monitoring of vaccine hesitancy and its associated factors among parents should be conducted to guide health promotion.

Parental concerns about COVID-19 vaccine safety and hesitancy in Korea: implications for vaccine communication

“…As seen in our regression analysis, parents' perception of the vaccine safety did not differ between the acceptance group and the hesitancy group, but concerns about adverse reactions had a negative effect on parents' intention to vaccinate their children. This finding is consistently observed in other studies as well, 18,19 which means that concerns about adverse reactions do not simply reflect misinformation that can be solved by educating parents about vaccine safety and some hesitancy originates in persistent psychological traits intuitively. 33 Because this psychological reactance is likely to affect parents of younger children, makes communication with physicians less effective, and results in hesitancy to vaccination, [34][35][36] alternative communication strategies tailored to this population are required.…”

“…The predictors of parents' intention to vaccinate their children with COVID-19 vaccine were analyzed using a multivariate binary logistic regression ( which is consistent with most studies from different countries. 15,18,19 Of note, parents of younger children were less likely to vaccinate their children even though they already got vaccinated or were willing to vaccinate themselves. This finding suggests that parents seem to expect greater standards of safety profiles from vaccines for younger children.…”

“…This finding suggests that parents seem to expect greater standards of safety profiles from vaccines for younger children. Parents of younger children may have more concern about potential long-term adverse effects, which was also the most important factor of vaccine hesitancy in many other studies 4,6,[18][19][20] . Also, this finding could be related with the widely known fact that adults of younger ages or younger children with COVID-19 have mild symptoms and clinical courses.…”

“…Most studies have consistently shown that concerns about adverse reactions of the vaccine and unknown long-term adverse effects are the most influential factors to parental hesitancy to COVID-19 vaccine. 13,15,18,19 In particular, as the number of people who access information about vaccines through social media and internet messages increases, there is a growing concern of having misinformation or mistrust about vaccine from unreliable sources. 4,[24][25][26] It suggests that providing reliable information on vaccine safety should be considered as a top priority.…”

“…27 This suggested that acceptance rates may fluctuate across different time points and epidemic waves according to parents' experiences and information about adverse reactions or breakthrough infections, which is consistent with other study that performed surveys before and after the implementation of COVID vaccination. 18 Therefore, it is necessary to continuously pay attention to and monitor changes in parental intentions to improve vaccination rates.…”