Parent Acceptance toward Inactivated COVID-19 Vaccination in Children with Acute Lymphoblastic Leukemia: The Power of Oncologist and Alliance

Abstract

Objectives: The current study aims to survey the willingness of parents to vaccinate their children, who are childhood acute lymphoblastic leukemia survivors (CALLS), and identify factors associated with vaccine acceptance. Methods: Parents of CALLS on/off treatment, with the general condition of being amendable to vaccination, were recruited for interviews with attending oncologists about COVID-19 vaccination acceptance from July to November 2021 in China. After controlling for socioeconomic factors, the Association of Oncologists’ recommendations and parent–oncologist alliance with acceptance status were investigated. For validation, propensity score-matched (PSM) analysis was used. Results: A total of 424 families were included in the study, with CALLS mean remission age of 5.99 ± 3.40 years. Among them, 91 (21.4%) agreed, 168 (39.6%) hesitated, and 165 (38.9%) parents disagreed with the vaccination. The most common reason that kept parents from vaccinating their children was lack of recommendations from professional personnel (84/165, 50.9%), and massive amounts of internet information (78/175, 44.6%) was the main nonhealthcare resource against vaccination. Logistic regression analysis showed that only the recommendation from the oncologist was associated with parents’ vaccine acceptance (OR = 3.17, 95% CI = 1.93–5.20), as demonstrated by PSM comparison (42 in recommendation group vs. 18 in nonrecommendation group among 114 pairs, p < 0.001). An exploratory analysis revealed that parents with a better patient–oncologist alliance had a significantly higher level of acceptance (65.6% in alliance group vs. 15.6% in nonalliance group among 32 pairs, p < 0.001). Conclusions: Due to a lack of professional recommendation resources and the potential for serious consequences, parents were generally reluctant to vaccinate their CALLS. The recommendation of oncologists, which was influenced by the parent–oncologist alliance, significantly increased acceptance. This study emphasizes the critical role of oncologists in vaccinating cancer survivors and can be used to promote COVID-19 vaccines among vulnerable populations.

Willingness and hesitancy of parents to vaccinate against COVID-19 their children ages 6 months to 4 years with frail conditions in Italy

“…Among parents who have sought information about this vaccination for their child from this source the odds of being willing to vaccinate were 83% higher as compared to those who had received information from other sources and 68% higher compared to those who did not receive any. This result support previous publications in the literature which underline the significant and positive influence of pediatricians and other healthcare professionals on the individuals’ attitudes and behaviors with those who had received information from this source that were more likely to accept or to receive a vaccination than those who did not use this source ( 11 , 13 , 30 , 45 , 46 ). However, since slightly more than half had received information by their pediatricians about the COVID-19 vaccine this may represents a limitation to receive the vaccine in the future.…”

Parents’ Uptake and Willingness towards Recommended Vaccinations for Their Children with Underlying Chronic Medical Conditions in Italy

“…Indeed, parents who had received a recommendation and those who had acquired information from physicians were more likely to have vaccinated their child and to intend to vaccinate their child with all recommended vaccinations. These findings highlight the central role played by physicians in the parents’ education and decisions and confirm previous studies that showed the positive influence of receiving a physicians’ recommendation on the populations’ attitudes and behaviors with a higher vaccination willingness and coverage [ 15 , 19 , 21 , 22 , 23 , 24 ]. However, it is necessary to underline that only one-fourth of the sample had received a recommendation from physicians and, therefore, it is imperative to provide educational activities to the healthcare workers particularly aiming to raise their awareness about vaccines’ efficacy and to recommend vaccinations for children with chronic medical conditions.…”

Midwives’ Knowledge, Attitudes, and Practice Regarding COVID-19 Vaccination for Pregnant Women: A Nationwide Web-Based Survey in Italy

“…This value was higher than the 37.5% in a sample of midwives in France [ 20 ]. As indicated in other surveys, a HCW’s recommendation has been shown to be one of the main factors influencing individual’s perceptions and practices about vaccinations [ 14 , 34 , 35 , 36 ] and the lack of a recommendation is often a reason for not being immunized [ 14 , 37 , 38 , 39 ]. Understanding the barriers is necessary for developing interventions that could increase the vaccination coverage.…”