Caregivers' Willingness to Accept Expedited Vaccine Research During the COVID-19 Pandemic: A Cross-sectional Survey

Abstract

Purpose To determine predictors associated with caregivers’ willingness to accept an accelerated regulatory process for Coronavirus disease 2019 (COVID-19) vaccine development. Methods An international cross-sectional survey of 2557 caregivers arriving with their children to 17 pediatric Emergency Departments (ED) across six countries from March 26 to June 30, 2020. Caregivers were asked to select one of four choices they agreed with the most regarding a proposed COVID-19 vaccine approval process, in addition to questions regarding demographics, the ED visit, and attitudes about COVID-19. Univariate analyses were conducted using the Mann-Whitney test for comparing non-normal continuous variables, independent t-test for comparing normally distributed continuous variables, and Chi-square or Fisher’s exact test for categorical variables. Variables of interest subsequently underwent a multivariable logistic regression analysis to determine independent factors associated with caregivers’ willingness to accept abridged COVID-19 vaccine development. A p-value less than 0.05 was considered significant. Findings Almost half (1101/2557; 43%) of caregivers reported that they are willing to accept less rigorous testing and post-research approval for a new COVID-19 vaccine. Independent factors associated with willingness to expedite COVID-19 vaccine research included children that were up-to-date on their vaccination schedule (Odds Ratio (OR) = 1.72, 95% Confidence Interval (CI) = 1.29-2.31), caregivers concerned that they had COVID-19 at the time of survey completion in the ED (OR = 1.1, 95% CI 1.05-1.16), and caregivers that intend to vaccinate their children against COVID-19 if a vaccine becomes available (OR = 1.84, 95% CI 1.54-2.21). Mothers completing the survey were less likely to approve changes in the vaccine development process (OR = 0.64, 95% CI = 0.53-0.78). Implications Less than half of caregivers in a global sample are willing to accept abbreviated vaccine testing during the COVID-19 pandemic. As part of an effort to increase acceptance and uptake of the new vaccine, especially in order to protect children, public health strategies and individual providers should understand caregivers’ attitudes towards approval of the vaccine and consult them appropriately.

Confidence and Receptivity for COVID-19 Vaccines: A Rapid Systematic Review

“…All except seven had national/state representative samples through random selection from the targeted population (e.g., via voter registration or phone numbers) or large national/international opt-in panels, many stratified by demographics. The other seven were convenience samples utilizing social media [2,7,[16][17][18] or recruiting posters [19,20].…”

“…There have been substantial variations in COVID-19 vaccine receptivity between countries [8,[20][21][22], states within the US [9,[23][24][25][26], and subgroups. Among America surveys, the highest intended acceptance of 72% was reported by Morning Consult in early April [27].…”

“…In China, while 91.3% showed intention to accept, 47.8% would delay until confirmed safe [29]. On the other hand, one international survey found 43% willing to accept less stringent standards [20]; an American survey reported that 59% agreed that providing more people access outweighs the risks of an accelerated process [30].…”

Letter to the editor to: Verger P and Dubé E. Restoring confidence in vaccines in the COVID-19 era, expert review of vaccines, 2020; 19(11):991-3

“…Compared to males, more females were unsure about safety of COVID-19 vaccine (29.4% vs 17.1%, P = 0.04) this could be because fewer females compared to males had access to information resources. In other surveys too females were more vaccine hesitant [4,9], and mothers, compared to fathers of children aged <18 years, were reluctant to accept abbreviated vaccine development process (odds ratio OR 0.6; 95% confidence interval 0.5-0.8) [11].…”

Reply

“…In both influenza and future COVID-19 vaccines, and in both the international COVIPAS sample and the one from Kuwait, prior immunization of children against influenza predicted willingness to vaccinate in the future. While many parents are not planning to vaccinate their children (or themselves), others told us that they are eager to see approved COVID-19 vaccines, and were even willing to accept less rigorous testing and post-research approval of a new inoculation [ 3 ].…”