Clinicians should ask pertinent questions to help identify unvaccinated parents and caregivers who are open to giving their children the COVID-19 vaccination.

Vaccine hesitancy continues to be a complex threat to global health, especially during the ongoing COVID-19 pandemic. Research shows that the willingness of parents and caregivers to vaccinate their children against COVID-19 has decreased over the course of the pandemic.

“Parents and caregivers want what’s best for their children, but they have questions about the efficacy and safety of COVID-19 vaccines,” says Ran D. Goldman, MD. “If parents or caregivers are concerned about long-term vaccine-related adverse effects, they may be unwilling take the vaccine themselves or to get their children vaccinated.”

Parental and caregiver acceptance of the COVID-19 vaccine for themselves is identified as the best predictor of their child getting the vaccine. “However, targeting only vaccinated parents and caregivers may miss critical opportunities to immunize children,” Dr. Goldman says. “It’s important to identify factors associated with the willingness of parents and caregivers to vaccinate their children—despite not being immunized themselves—against COVID-19 to help public health agencies with directing information to specific groups of parents and caregivers.”

Despite Being Unvaccinated, Some Caregivers Plan to Vaccinate Their Kids

For a study published in Preventive Medicine, Dr. Goldman and colleagues sought to determine factors linked with willingness of parents and caregivers to vaccinate children even though they were not immunized themselves against COVID-19. Data were analyzed from the International COVID-19 Parental Attitude Study (COVIPAS), a multinational cohort study that recruited parents and caregivers of children aged 0-18 from 21 EDs spanning across the United States, Canada, Israel, and Switzerland from November 2021-December 2021.

Parents and caregivers presenting with children to EDs were asked to participate in an online anonymous survey. The survey inquired about demographic characteristics, chronic illnesses, immunization status, perceptions of the likelihood their child or themselves had COVID-19 during their ED presentation, and information on exposure and COVID-19 illness at home. A multivariable logistic regression model was developed to assess links between prespecified factors and a willingness to vaccinate.

In total, 4,536 parents and caregivers completed the survey, 19.4% of whom were unvaccinated. “We found that 7.0% of unvaccinated parents and caregivers planned to vaccinate their children,” says Dr. Goldman. “We also identified two groups of caregivers that were more than three times as likely to plan to immunize their children. These included unvaccinated parents and caregivers with children who had their childhood vaccines up to date and those who reported being very worried their child had COVID-19 in the ED (Table). Simply stated, parents and caregivers were more likely to plan to vaccinate their children if they expressed concerns about getting infected with COVID-19.”

Dig Deeper When Discussing Vaccine Hesitancy to Avoid Assumptions

Despite the initial enthusiasm and willingness to forego regulatory procedures when the COVID-19 vaccines were approved, findings suggest there continues to be parental and caregiver hesitancy about vaccinating children against COVID-19 over the course of the pandemic. “Our research shows that a small group of parents and caregivers who are hesitant to vaccinate themselves is willing to vaccinate their children,” Dr. Goldman says. “Collectively, our findings stress that healthcare professionals should not assume unvaccinated caregivers will refuse to vaccinate their children.”

In the general population, key factors for vaccinating children for COVID-19 include the child’s age, the parent’s or caregiver’s age, gender, level of education, and prior exposure to someone with the infection. However, these factors are not as helpful with differentiating the willingness of unvaccinated parents and caregivers to vaccinate their children.

“Knowledge is power,” says Dr. Goldman. “When caring for families that are unvaccinated, primary care providers and ED physicians should ask two questions at the time of presentation. First, what is the child’s vaccination status? Second, what concerns do parents and caregivers have about COVID-19 vaccines? Asking these questions may help identify parents and caregivers who are open to giving their children the vaccine.”