COVID-19 Vaccine Acceptance Among US Parents: A Nationally Representative Survey

Abstract

Background Little was known about US parental attitudes, beliefs, and intentions surrounding coronavirus disease 2019 (COVID-19) vaccines for children before their introduction. Methods An online cross-sectional nationally representative survey of US parents/guardians of children < 18 years old via Ipsos KnowledgePanel, fielded from October 26, 2021 to November 30, 2021. Results Response rate was 64.2% (3230/5034). For children ages 0–4 years, 51.5% of parents were likely to have their children vaccinated, and for ages 5–11 and 12–17, 54.0% and 69.7% of parents, respectively, reported they were likely to vaccinate or had already vaccinated their children. Among respondents with unvaccinated children, 25.2% (ages 0–4) and 22.0% (ages 5–11) reported they would seek COVID-19 vaccination for their children as soon as authorization occurred. Factors associated with willingness to have children receive a COVID-19 vaccine were: belief in benefits of COVID-19 vaccination (odds ratio [OR] = 6.44, 5.68, 4.57 in ages 0–4, 5–11, and 12–17 respectively), acceptance of routine childhood vaccines (OR = 6.42, 5.48, 1.76), parental COVID-19 vaccination (OR = 1.85, 3.70, 6.16), perceptions that pediatric COVID-19 is severe (OR = 1.89, 1.72, 1.35), Hispanic ethnicity (OR = 2.07, 2.29, 2.60), influenza vaccine acceptance (OR = 1.07, 0.88, 1.62), presence of children of another age group in the household (OR = 0.71, 0.71, 0.65), and attitudinal barriers to COVID-19 vaccination (OR = 0.30, 0.26, 0.49). Conclusions Belief in the benefits of COVID-19 vaccination and acceptance of routine childhood vaccines are the strongest predictors of intention to vaccinate children. Further research is needed to track how parental attitudes change as more data about pediatric COVID-19 vaccines become available and how intentions translate into pediatric vaccine uptake.

Coronavirus Disease-2019 Vaccine Hesitancy

“…However, roughly 40% of parents with children 0-11 years old wanted to “wait and see” before vaccination, and another 36% would not let their children get a COVID-19 vaccine. Parents in that study who had received a COVID-19 vaccine themselves were 1.9, 3.7, and 6.2 times more likely to accept COVID-19 vaccination for their 0-4, 5-11, and 12-17 year old children, respectively; however, this effect was not statistically significant for parents of children 0-4 years old, the age group for which a vaccine had not yet been authorized at the time of the study 30 . Acceptance of COVID-19 vaccination for children is also associated with acceptance of routine childhood immunizations and prior receipt of a seasonal influenza vaccine 30 .…”

“…This trajectory is consistent with surveys showing that one-third of U.S. parents wanted to “wait and see” before vaccinating their children 24 , 27 , 28 , 29 . In October-November 2021, similar proportions of U.S. parents of 5-11 year old children reported wanting to wait before vaccinating their children, with 22-27% wanting to vaccinate them as soon as possible 24 , 30 . A vaccine was authorized for children 5-11 years old in the U.S. on October 29, 2021, and by the end of January 2022, 31% of U.S. children 5-11 years old had received at least a first dose of COVID-19 vaccine.…”

“…In general, surveys performed later in the pandemic in late 2021 showed greater levels of parental acceptance of COVID-19 vaccines compared to surveys performed in 2020 and early 2021 29 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 . A nationally representative survey of U.S. parents in October-November 2021 found that for children ages 0-4 years, 52% of parents were likely to have their children vaccinated, and for ages 5-11 and 12-17, 54% and 70% of parents, respectively, reported they were likely to vaccinate or had already vaccinated their children 30 . However, roughly 40% of parents with children 0-11 years old wanted to “wait and see” before vaccination, and another 36% would not let their children get a COVID-19 vaccine.…”

“…Parents must balance the perceived risks of COVID-19 disease against perceived risks and benefits of COVID-19 vaccination. The media often report that pediatric COVID-19 disease is mild, but parental perception that pediatric COVID-19 disease is severe is a predictor of positive vaccination intention for children 0-4 and 5-11 30 . At the same time, parents report concerns about the side effects of COVID-19 vaccines, and parents with attitudinal barriers to COVID-19 vaccination are less likely to accept the vaccine for their children 29 , 30 , 62 , 67 .…”

“… 87 Thus, public perception that COVID-19 was a relatively benign illness in children was common and has contributed to parental resistance to vaccination. 30 , 31 , 61 In addition, as the COVID-19 vaccination campaign progressed and discussion of booster doses became public, some construed the need for boosters to mean that the vaccines were not effective. Contributing to this misperception in children specifically were the effectiveness results from the clinical trials in children, particularly those less than 5 years of age (or 6 for the Moderna vaccine).…”