Parents' intention for their children to receive COVID-19 vaccine: Implications for vaccination program in Macao

Abstract

IntroductionThe decision about vaccinating children is subject to their parents' decision. To inform strategies that support full vaccination coverage, it is important to understand the parents' vaccination attitude and tendency to act. This study aims to investigate the intention and the factors affecting parents' decision-making about vaccinating their children.MethodsA cross-sectional, self-administered online questionnaire was completed by parents of children aged 3–12 yeas in Macao between 7 March and 17 April 2022. The survey tool was informed by the Theory of Planned Behavior (TPB) which composes of the variable “intention” and three TPB constructs (Attitude, Subjective Norm, and Perceived Behavioral Control). Respondents rated their level of agreement on the construct statements using a 5-point Likert scale. Multiple linear regression analysis was used to determine if the TPB constructs were predictors of parents' intention.ResultsA total of 1,217 parents completed the questionnaire. The majority of participants were mothers (83.2%), aged 31–40 years (62.7%), having two or more children (74.1%), had at least one dose of COVID-19 vaccine (84.4%) and considered themselves knowledgeable about the vaccine (62.1%), all of which were significantly associated with the intention to vaccinate their children (all p < 0.05). Their intention varied from negative (19.1%), neutral (38.4%) to positive (42.5%). Respondents were mostly concerned about the serious side effects that the COVID-19 vaccine (mean = 3.96 ± 1.23), highly acknowledged the expectation by the school (mean = 3.94 ± 1.15) and the community (mean = 3.90 ± 1.19) of children vaccination, and rated highly the ease of making necessary arrangement (mean = 3.93 ± 1.25). In the multiple linear regression model which explained 63.5% of the variance in the intention-to-vaccinate their children, only Attitude (B = 0.52, p < 0.001) and Subjective Norm (B = 0.39, p < 0.001) were identified as strong predictors. The major reasons for not having intention were safety concerns (n = 646/699, 92.4%). Participants' most trusted local information sources were doctors (n = 682), government (n = 426) and healthcare professional organizations (n = 416).ConclusionsVaccinating children with COVID-19 vaccine is a complex decision-making for parents. A key to a successful COVID-19 vaccination program is effective communication about the safety profile and the usage experiences warranting the integration of reliable information sources across different healthcare sectors.

Understanding caregivers' decision to vaccinate childhood cancer survivors against COVID‐19

“…Both studies found all constructs, attitudes, subjective norms, and perceived behavioral control to be related to intention. Conversely, a study conducted in China after the authorization for COVID‐19 vaccines among children showed similar results to ours and did not find perceived behavioral control to be indicative of parents' intentions 31 . Based on our findings and the previous research, we can conclude that perceived behavioral control is important for caregivers when vaccines are not accessible for their child.…”

“…Furthermore, background variables (e.g., sociodemographic characteristics) only indirectly influence intention through attitudes, subjective norms, and perceived behavioral control. The TPB has been applied to study different health behaviors, including COVID‐19 vaccination decisions among adults 27–29 and parents for their children in the general population 29–32 . We aimed to use the TPB to identify antecedents contributing to caregivers' decision to vaccinate young CCS against COVID‐19, including health literacy related to COVID‐19 aspects (referred to as “COVID‐19 health literacy” hereafter) and frequency of COVID‐19 information‐seeking.…”

Parents’ Readiness to Vaccinate Their Children Aged 5 to 17 Years Against Covid-19 and Its Associated Factors in Lira District, Uganda

“… 27 Studies show that parents are most concerned about the serious side effects that are associated with the COVID-19 vaccine. 12 Possible causes of the vaccine’s hesitancy may have been the vaccine’s newness and a lack of strong evidence of its safety. In Uganda, requiring written consent may cause anxiety among those planning to get vaccinated.…”

“… 10 Studies on parents’ readiness to vaccinate their children against COVID-19 have been conducted, revealing inconsistent results. 11 , 12 In Japan, close to 60% of parents remained hesitant to vaccinate their children against COVID-19, 10 in Turkey, 56.8% of parents were willing to vaccinate their children, 13 in Saudi Arabia, 52% were hesitant to vaccinate their children, 14 in the UK, approximately 48% of the participants were willing to vaccinate their children. 15 In Italy, 10% of the participants were hesitant about immunization.…”

Parental intention on getting children COVID-19 vaccinations: Invariance evaluation across parenting roles and COVID-19-like symptoms experiences among Iranians during the pandemic period

“… 23–28 However, with strong educational efforts by health experts and authorities, there was an increase in the quality of knowledge 15 and consequently, COVID-19 vaccine uptake. 28 Previous studies have associated formal knowledge of COVID-19, adherence to COVID-19-related policies, and vaccination intentions. 15 , 28 A previous study also revealed that cogent information on COVID-19 vaccine helped increase parents’ intentions to vaccinate their children.…”