Willingness and influential factors of parents to vaccinate their children against the COVID-19: a systematic review and meta-analysis

Abstract

Background: Coronavirus disease 2019 (COVID-19) vaccine uptake among children will be critical in limiting the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the disease. Parents are key decision-makers for whether their children will receive a COVID-19 vaccine. Objective: To estimate parents willingness to vaccinate their children against the COVID-19, and to investigate the predictors for their decision. Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines for this systematic review and meta-analysis. We searched Scopus, Web of Science, Medline, PubMed, ProQuest, and CINAHL from inception to August 11, 2021. The review protocol was registered with PROSPERO (CRD42021273125). We applied a random effect model to estimate pooled effects since the heterogeneity was very high. We used subgroup analysis and meta-regression analysis to explore sources of heterogeneity. Results: We found 17 studies including 45,783 parents. The overall proportion of parents that intend to vaccinate their children against the COVID-19 was 56.8% (95% confidence interval: 51.8-61.8%). Parents willingness ranged from 29% to 72.7%. Studies quality, sample size, data collection time, and the continent that studies were conducted did not affect the results. The main predictors of parents intention to vaccinate their children against COVID-19 were male gender, older age of parents and children, higher socio-economic status, white race, positive attitudes toward vaccination, higher levels of knowledge, and higher levels of perceived threat from the COVID-19, worry, fear, and anxiety. Conclusions: Parents willingness to vaccinate their children against the COVID-19 is moderate and several factors affect this decision. Understanding parental COVID-19 vaccine hesitancy does help policymakers to change the stereotypes and establish broad community COVID-19 vaccination. Identification of the factors that affect parents willingness to vaccinate their children against COVID-19 will provide opportunities to enhance parents trust in the COVID-19 vaccines and optimize children uptake of a COVID-19 vaccine.

Parents’ intention to vaccinate their 5-11 years old children with the COVID-19 vaccine: rates, predictors and the role of incentives

“…shown in a recent systematic review [21]. Several socio-demographic characteristics that we found to be associated with parents' intention to vaccinate their children are consistent with previous studies.…”

“…Several socio-demographic characteristics that we found to be associated with parents' intention to vaccinate their children are consistent with previous studies. For example, these previous studies found that significantly higher proportions of males [22][23][24], older parents [21], higher educational level [23,25] and higher income [25,26] exhibited higher intentions to vaccinate children against COVID-19.…”

Predictors of parents’ intention to vaccinate their children against the COVID-19 in Greece: a cross-sectional study

“…Only one study in Turkey (Yigit et al, 2021) reported a percentage (29%) lower than the one we found. Several other studies worldwide found that parents’ intention to vaccinate their children is higher than our study and ranges from 36.7% to 72.7% (Galanis et al, 2021). In particular, studies in Europe (United Kingdom, Germany and Italy) found that the proportion of parents’ that intend to vaccinate their children ranges from 48% to 60.4% (Bell et al, 2020; Brandstetter et al, 2021; Montalti et al, 2021).…”

“…According to a meta-analysis (Galanis et al, 2021), parents’ intention to vaccinate their children against the COVID-19 ranges from 29% to 72.7%, while the overall proportion of parents that intend to vaccinate their children is 56.8%. Parents’ willingness to vaccinate their children against COVID-19 is affected by several factors such as gender (Goldman et al, 2020; Kelly et al, 2021; Montalti et al, 2021; Yigit et al, 2021), age of parents and children (Goldman et al, 2020; Kelly et al, 2021; Montalti et al, 2021; Skjefte et al, 2021; Szilagyi et al, 2021), socio-economic status (Brandstetter et al, 2021; Hetherington et al, 2021; Kelly et al, 2021; Montalti et al, 2021; Skjefte et al, 2021; Szilagyi et al, 2021; Wang et al, 2021; Yigit et al, 2021), race (Bell et al, 2020; Kelly et al, 2021; Scherer et al, 2021; Teasdale et al, 2021), attitudes toward vaccination (Goldman et al, 2020; Kelly et al, 2021; Ruggiero et al, 2021; Skjefte et al, 2021; Yilmaz and Sahin, 2021; Zhang et al, 2020), and information about the COVID-19 (Brandstetter et al, 2021; Montalti et al, 2021; Zhang et al, 2020).…”

Development and validation of a questionnaire to measure attitudes toward COVID-19 vaccination and pandemic

“…From early 2021, the ability to vaccinate against the COVID-19 with safe and effective vaccines is the best hope to control the pandemic (Baden et al, 2021; Haas et al, 2021; Polack et al, 2020). Unfortunately the intention to vaccinate against the COVID-19 is low not only in the general population but also among healthcare professionals with some countries showing higher hesitancy rates compared with others (Cascini et al, 2021; Galanis et al, 2020; Galanis, Vraka, Siskou, et al, 2021a, 2021b; Luo et al, 2021; Salomoni et al, 2021; Snehota et al, 2021). Moreover, several factors influence the intention to vaccinate against the COVID-19 such as socio-demographic characteristics (e.g.…”