Worldwide Estimation of Parental Acceptance of COVID-19 Vaccine for Their Children: A Systematic Review and Meta-Analysis

Abstract

Currently, the best method to well control the spread of COVID-19 without severe mental health problems is to reach herd immunity. Therefore, the vaccination rate of the COVID-19 vaccine is critical. Among the populations, children are the vulnerable ones to get vaccinated; therefore, it is important to assess parents’ and guardians’ willingness to have their children vaccinated. The present systematic review and meta-analysis synthesized evidence to estimate the parents’ acceptance rate of COVID-19 vaccination toward their children. Additionally, factors explaining the acceptance rate were investigated. Four academic databases (PubMed, Scopus, Web of Science, and ProQuest) together with Google Scholar were searched, and the references of the included publications were searched as well. Using the PECO-S framework (population, exposure, comparison, outcome, and study design), observational studies of cross-sectional, cohort, or case-control studies were included. The outcome was parents’ or guardians’ willingness to let their children be vaccinated. The studies included in the present review were restricted to English and peer-reviewed papers published between December 2019 and July 2022. A total of 98 papers across 69 different countries with 413,590 participants were included. The mean age of the parents was 39.10 (range: 18–70) years and that of their children was 8.45 (range: 0–18) years. The pooled estimated prevalence of parental acceptance to vaccinate their children with the COVID-19 vaccine was 57% (98 studies, 95% CI: 52–62%, I2: 99.92%, τ2: 0.06). Moreover, data collection time was a significant factor explaining parental willingness in the multivariable meta-regression, with a 13% decrease in parental willingness by each month increase in time, explaining 11.44% of variance. Qualitative synthesis results showed that parents’ COVID-19 vaccine knowledge, trust in theCOVID-19 vaccine, and facilitators in vaccination (e.g., low cost, good vaccine accessibility, and government incentive) were significant factors for higher willingness, while mental health problems (e.g., having worries and psychological distress) were significant factors for lower willingness. Given that the acceptance rate was relatively low (57%) and does not achieve the requirement of herd immunity (i.e., 70%), governments and healthcare authorities should try to elevate parents’ knowledge and trust in the COVID-19 vaccine, facilitate in vaccination, and reduce their mental difficulties to improve the overall vaccination rate among children.

Ethical Challenges Involved in COVID-19 Vaccine Mandates for Children: A Systematic Review

“…According to research, 49% of LMIC parents agreed to vaccinate their children and believed that COVID-19 vaccines would be effective in containing the pandemic [ 40 ]. The worldwide parental acceptance rate for COVID-19 vaccines is 58% [ 41 ]. Communication and policies that provide credible information about vaccination [ 42 ], parents’ knowledge and trust about vaccine, cost, accessibility, and government incentives were the factors that encouraged parents to vaccinate their children [ 41 ].…”

“…The worldwide parental acceptance rate for COVID-19 vaccines is 58% [ 41 ]. Communication and policies that provide credible information about vaccination [ 42 ], parents’ knowledge and trust about vaccine, cost, accessibility, and government incentives were the factors that encouraged parents to vaccinate their children [ 41 ]. Vaccine acceptance is not directly proportional to a nation’s income distribution, but rather to an individual’s income and educational qualifications, belief in the vaccine’s ability and safety, and trust in vaccine science [ 39 ].…”

COVID-19 vaccination rates among adolescents (12–17 years) by immigrant background and sociodemographic factors: A nationwide registry study in Norway

“…Some potential drivers behind the differences we see in vaccination rates between the age groups may be connected to differing recommendations and offers of vaccination(s) from the Norwegian health authorities. Although the vaccine was made available for both age groups examined in this study during Autumn 2021, only the older group of adolescents [16] , [17] was recommended the vaccine, whereas there was never a general recommendation to vaccinate the young adolescents [12] , [13] , [14] , [15] . Previous studies have shown parents of adolescents to be more willing to vaccinate their children than those of young children [11] , [12] , which might also impact the vaccination rates of the younger group.…”

“…The first COVID-19 vaccine in Norway was administered on December 27 th , 2020 and vaccines were offered to defined risk groups for the first part of 2021 before being made available to the broader part of the population. Adolescents with specific, severe underlying diseases aged between 16 and 17 years were recommended the vaccine from February 8 th , 2021 [16] , and adolescents between 12 and 15 years from June 15 th , 2021 [18] . Adolescents without the specified diagnoses and aged 16 to 17 years were recommended vaccines from mid-August, 2021.…”

An Exploratory Study of Rural Parents’ Knowledge and Attitudes About HPV Vaccination Following a Healthcare Visit With Their Child’s Primary Care Provider

“…In addition to high vaccine hesitancy rates for the HPV vaccine among parents, rates of vaccine hesitancy are high for vaccination overall and may be increasing. 44,45 For instance, Alimoradi et al 46 reviewed 98 peer-reviewed papers from nearly 70 countries in order to understand parental acceptance to the COVID-19 vaccine. Their findings show a low prevalence of such acceptance, with a pooled estimated prevalence of 57% (far lower than what may be necessary to reach herd immunity for COVID-19).…”