Vaccine Hesitancy Among Canadian Mothers: Differences in Attitudes Towards a Pediatric COVID-19 Vaccine Among Women Who Experience Intimate Partner Violence

Abstract

Objectives Vaccine hesitancy (VH) in maternal decision-making is important to understand to achieve community immunity targets and optimize pediatric COVID-19 vaccine adoption. COVID-19 is exacerbating the risk of intimate partner violence (IPV) for women in abusive relationships, a known risk factor for maternal VH. This project aimed to: (1) determine if IPV impacts maternal VH in Canada; and (2) understand maternal attitudes towards routine childhood vaccines and a pediatric COVID-19 vaccine in Canada. Methods As part of a cross-sectional, quantitative study, 129 women completed an online survey. IPV was assessed using the Abuse Assessment Screen and the revised, short-form Composite Abuse Scale. The Parent Attitudes about Childhood Vaccines scale evaluated maternal attitudes towards routine vaccinations and a COVID-19 vaccine. Questions informed by the World Health Organization's Increasing Vaccination Model (IVM) evaluated perceived barriers and facilitators to COVID-19 vaccination. Results In total, 14.5% of mothers were hesitant towards routine childhood vaccines, while 97.0% were hesitant towards a COVID-19 vaccine. Experiencing IPV was significantly associated with maternal COVID-19 VH (W = 683, p < 0.05). Social processes were identified as instrumental barriers and facilitators to COVID-19 vaccination, meaning that social norms and information sharing among social networks are critical in maternal vaccination decision-making. Conclusions for PracticeThis study provides novel evidence of maternal IPV significantly impacting VH and the presence of strong maternal VH specific to a COVID-19 vaccine in the Canadian context. Further research is required to fully understand the factors that build confidence and mitigate hesitancy in mothers, especially mothers who have experienced IPV.

The association between emotional and physical intimate partner violence and COVID-19 vaccine uptake in a community-based U.S. Cohort

“…There is a paucity of research looking at the relationship between IPV and vaccination decisions. In a recent study to better understand maternal attitudes towards pediatric vaccination in Canada, IPV experience was significantly associated with maternal hesitancy toward the COVID-19 vaccine, but not with hesitancy toward routine childhood vaccines ( Davidson et al, 2023 ). Furthermore, though beyond the scope of this analysis, others have highlighted the ways in which IPV, especially during a public health emergencies, can limit survivors’ abilities to meet their daily needs ( Ragavan et al, 2022 ).…”

“…One study among Mexican-American female adolescents found that a higher proportion of those who had experienced interpersonal violence were more accepting of the HPV vaccine ( Champion, 2017 ), while a study among women and girls in Nigeria living with and at high risk for HIV found that being a survivor of physical IPV or emotional abuse was associated with higher odds of COVID-19 vaccine hesitancy ( Folayan et al, 2022 ). A study of Canadian mothers found that those who reported experiencing IPV were significantly more hesitant toward the pediatric COVID-19 vaccine ( Davidson et al, 2023 ). In addition, several studies in the United States, Bangladesh, and India have found that women who experience IPV are less likely to fully immunize their children ( Bair-Merritt et al, 2008 , Hasan et al, 2015 , Paul and Mondal, 2021 , Sabarwal et al, 2012 ).…”