COVID-19 vaccine for children below 5 years: most parents still hesitant

Widespread hesitancy around COVID-19 vaccination in children below 5 years does exist, even among parents showing preference for vaccinating their child in this age group, a US study suggests.

“[Although] children aged 6 months through 4 years have become eligible for COVID-19 vaccination … [our] results suggest that only a minority of parents of children in this age group are eager to vaccinate their children within the first few months of eligibility, with widespread concerns about COVID-19 vaccination for this age group,” said the researchers.

This cross-sectional study fielded an internet-based survey in a nonprobability sample of US parents of children aged 6 months through 4 years. The final weighted sample comprised 2,031 respondents, with a 74-percent participation rate. More than half (55 percent) of the participants identified as male and about 90 percent were between ages 25 and 49 years. Sixty percent received at least one dose of a COVID-19 vaccine. [JAMA Network Open 2022;5:e2227437]

Respondents with at least one child in the two age groups identified (6–23 months and 2–4 years) were randomized to one of these groups. Parents with more than one child in an age group were given instructions to consider the child with the most recent birthday when providing responses.

Nearly half (46 percent) of the respondents indicated that they will ‘definitely’ or ‘probably’ have their child in this age group vaccinated against COVID-19 once they became eligible.

However, only 19 percent intended to do so within 3 months of the child’s eligibility. About 50 percent indicated their intention to wait longer, while 34 percent were uncertain when or if they would have their child vaccinated.

A total of 571 respondents indicated that they ‘definitely will not’ vaccinate their child in this age group.

In the subgroup of respondents who expressed some possibility of having their child in this age group vaccinated against COVID-19 (n=1,510), 26 percent noted that they would do so within 3 months of the child’s eligibility, 50 percent would wait longer, while 24 percent did not know when or if they would vaccinate their child.

“The hesitancy of parents of children in this age group to get their child a COVID-19 vaccine may reflect the fact that even parents who reported that they ‘probably will’ vaccinate their child have at least one major concern about their child receiving a COVID-19 vaccine,” the researchers explained.

Top concerns: vaccine efficacy, safety

“Vaccine safety and efficacy were parents’ top concerns,” said the researchers. “[R]eceiving more information about safety and efficacy were the top facilitators to COVID-19 vaccination for this age group.” Other facilitators are full FDA approval of a vaccine for this age group and more severe COVID-19 cases.

Regarding COVID-19 vaccination locations for this age group, parents trusted a doctor’s office/clinic the most (64 percent), followed by the local pharmacy (23 percent). About a quarter of respondents were amenable to having their child vaccinated in a different doctor’s office/clinic.

“Our results highlight the persistence of safety and efficacy concerns for COVID-19 vaccination,” the researchers stressed. Barring parents who were certain of getting their child vaccinated upon eligibility, the findings imply that every respondent had at least one concern about getting a COVID-19 vaccine for their child.

“Thus, considerable efforts to increase parental COVID-19 vaccine confidence for children aged 6 months through 4 years may be needed to maximize COVID-19 vaccination for this age group in the US,” the researchers concluded.