Caregivers name potential benefits and harms and availability of reliable information as main factors influencing their decision to vaccinate their child against COVID-19

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1. Nearly all participating caregivers listed the following as important influences on their decision to vaccinate their child against COVID-19: potential positive and negative effects from the vaccine, its impact on pre-existing medical conditions, and the availability of reliable information.

2. Caregivers who refuse COVID-19 vaccination perceive the vaccine to be ineffective and to have short- and long-term side effects. 

Evidence Rating Level: 4 (Below average)       

Study Rundown: In the United States, surveys among caregivers have found Black persons, Hispanic persons, and rural residents to have the highest rates of COVID-19 vaccine hesitancy for their children. Given these disparities, this study had two aims: 1) to explore attitudes toward COVID-19 vaccination among Black, Spanish-speaking, and rural non-Hispanic White (NHW) caregivers, and 2) to identify strategies to address caregivers’ confidence in COVID-19 vaccine for these high priority groups. The study team recruited 36 caregivers who belonged to at least one of these demographic groups and who had at least one child who was not vaccinated against COVID-19. The vaccine acceptors and refusers underwent key-informant interviews (KIIs), while the vaccine-hesitant caregivers participated in focus groups. Vaccine acceptors and refusers often expressed similar viewpoints and beliefs about vaccinating their children, including their trust in their physician and their desire for more information about vaccine side effects. Nearly all caregivers named potential benefits and harms and the availability of reliable information as important factors in their decision-making around COVID-19 vaccination. This study contributes to our understanding of what caregivers value most when considering COVID-19 vaccination. Moreover, this study’s findings informed the content design of the Mobile Vaccine Uptake (MoVeUP) Application (app), which aims to provide caregivers with personalized information about the COVID-19 vaccine. Next steps should include the evaluation of the effectiveness of the MoVeUP app on addressing vaccine hesitancy among caregivers in the highest priority groups for vaccination. 

Click to read the study in Pediatrics

Relevant Reading: Racial and ethnic differences in COVID-19 vaccination coverage among children and adolescents aged 5-17 years and parental intent to vaccinate their children – National Immunization Survey — Child COVID Module, United States, December 2020-September 2022

In-Depth [cross-sectional study]: This study evaluated the opinions and beliefs around COVID-19 vaccination of 36 Black, Spanish-speaking, or rural NHW caregivers from Delaware, New Mexico, Oklahoma, and South Carolina. All participants had at least one child between 2 and 17 years of age who was not vaccinated against COVID-19. Four caregivers were vaccine refusersrefusors, four were vaccine acceptors, and the remaining 28 were vaccine-hesitant. KIIs were conducted with vaccine acceptors and refuseors while vaccine-hesitant caregivers participated in focus groups. Transcripts from the interviews and focus groups underwent discourse analysis, summative qualitative content analysis, and thematic analysis. Across all three demographic groups, caregivers generally viewed doctors as trusted sources of information and social media as untrustworthy; however, they were conflicted on the trustworthiness of public health resources. Nearly all caregivers considered the following when making decisions around COVID-19 vaccination for their children: potential benefits and harms, the vaccine’s impact on pre-existing medical conditions, and the availability of reliable information. Caregivers almost universally preferred to decide themselves for their children to be vaccinated, rather than comply with public mandates. All refusers were concerned about perceived vaccine ineffectiveness and side effects. Rumors about the COVID-19 vaccine were most prevalent among NHW rural caregivers and included vaccine side effects, impacts on child development, low efficacy, and fear of governmental interference or religious consequences. 

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