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Ma M, Wu X, Zhao Q, Liu R, Li Q, Guo X, Shen Z, Tarimo CS, Feng Y, Zhao L, Ye B, Wu J, Miao Y. Temporal changes in factors associated with COVID-19 vaccine hesitancy among Chinese adults: Repeated nationally representative survey. SSM Popul Health 2024; 25:101574. [PMID: 38273868 PMCID: PMC10809179 DOI: 10.1016/j.ssmph.2023.101574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/27/2023] [Accepted: 11/28/2023] [Indexed: 01/27/2024] Open
Abstract
Background COVID-19 vaccine hesitancy has been cited as one of the main obstacles impacting vaccine coverage. However, factors that affect hesitancy may change over time. Understanding these evolving concerns and adapting strategies accordingly are crucial for effectively addressing vaccine hesitancy effectively and promoting public health. We aimed to explore the temporal changes in factors associated with COVID-19 VH during the COVID-19 pandemic and assess the dynamic evolution of VH. Methods In August 2022 and February 2023, repeated online surveys were undertaken to collect information from 5378 adults across four regions of China. Multiple linear regression models assessed the influencing factors of COVID-19 VH. The association between protective motive theory (PMT) (perceived severity, susceptibility, benefits, barriers, and self-efficacy) and VH was evaluated by structural equation modeling (SEM). Results Repeated measures showed that 573 (10.7%) and 1598 (29.7%) of the 5378 participants reported COVID-19 VH in the baseline and follow-up surveys, respectively. Educational levels, chronic disease, history of allergy, COVID-19 infection, and trust in medical staff and vaccine developers were positively associated with COVID-19 VH (P<0.05). The application of SEM revealed that perceived severity, susceptibility, vaccination barriers, and self-efficacy in the PMT directly impacted on VH (P<0.05). In addition, severity, susceptibility, benefits, and barriers had a significant direct effect on self-efficacy as β = 0.113, β = 0.070, β = 0.722, β = -0.516 respectively with P < 0.001. Conclusion The prevalence of COVID-19 VH was relatively low in the baseline survey and much higher in the follow-up survey, with a significant increase in hesitancy rates among mainland Chinese residents. Acknowledging the substantial impact on the shaping of COVID-19 VH, one must consider factors including perceived severity, susceptibility, vaccination barriers, and self-efficacy.
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Affiliation(s)
- Mingze Ma
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zheng Zhou, Henan, China
| | - Xiaoman Wu
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zheng Zhou, Henan, China
| | - Qiuping Zhao
- Henan Key Laboratory for Health Management of Chronic Diseases, Central China Fuwai Hospital, Central China Fuwai Hospital of Zhengzhou University, Zheng Zhou, Henan, China
| | - Rongmei Liu
- Henan Key Laboratory for Health Management of Chronic Diseases, Central China Fuwai Hospital, Central China Fuwai Hospital of Zhengzhou University, Zheng Zhou, Henan, China
| | - Quanman Li
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zheng Zhou, Henan, China
| | - Xinghong Guo
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zheng Zhou, Henan, China
| | - Zhanlei Shen
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zheng Zhou, Henan, China
| | - Clifford Silver Tarimo
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, China
- Department of Science and Laboratory Technology, Dar es Salaam Institute of Technology, Dar es Salaam, Tanzania
| | - Yifei Feng
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zheng Zhou, Henan, China
| | - Lipei Zhao
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zheng Zhou, Henan, China
| | - Beizhu Ye
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zheng Zhou, Henan, China
| | - Jian Wu
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zheng Zhou, Henan, China
| | - Yudong Miao
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zheng Zhou, Henan, China
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Wu J, Xia Q, Miao Y, Yu C, Tarimo CS, Yang Y. Self-perception and COVID-19 vaccination self-efficacy among Chinese adults: A moderated mediation model of mental health and trust. J Affect Disord 2023; 333:313-320. [PMID: 37084973 PMCID: PMC10116156 DOI: 10.1016/j.jad.2023.04.047] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/31/2023] [Accepted: 04/14/2023] [Indexed: 04/23/2023]
Abstract
BACKGROUND Optimal COVID-19 vaccination coverage is necessary to achieve community protection, and self-efficacy independently predict vaccination behavior. The current study examined the effect of self-perception on COVID-19 vaccination self-efficacy as well as potential mechanisms among Chinese adults. METHODS A cross-sectional survey was conducted from four cities in China (n = 6781). Models 4 and 8 in Hayes' PROCESS macro were used to test models. RESULTS Self-perception (β = 0.128, 95 % CI: 0.093-0.163) and self-perception ∗ mental health (β = 0.009, 95 % CI: 0.003-0.014) were positively associated with trust in doctors and vaccine developers, while mental health was negatively related to trust in doctors and vaccine developers (β = -0.483, 95 % CI: -0.629-0.337). Self-perception (β = 0.149, 95 % CI: 0.138-0.161), trust in doctors and vaccine developers (β = 0.185, 95 % CI: 0.177-0.194) and self-perception ∗ mental health (β = 0.003, 95 % CI: 0.002-0.005) were positively associated with COVID-19 vaccination self-efficacy. Mental health was negatively related to COVID-19 vaccination self-efficacy (β = -0.101, 95 % CI: -0.151-0.051). LIMITATIONS This cross-sectional study collected data through online questionnaires. CONCLUSIONS Our results demonstrated that the relationship between self-perception and COVID-19 vaccination self-efficacy was partially mediated by trust in doctors and vaccine developers. Both the correlation between self-perception and COVID-19 vaccination self-efficacy, and the relationship between self-perception and trust in doctors and vaccine developers were moderated by mental health. Findings confirm that increasing COVID-19 vaccination self-efficacy would be facilitated by improvements in self-perception, mental health, and trust in doctors and vaccine developers.
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Affiliation(s)
- Jian Wu
- Department of Health management, College of Public Health, Zhengzhou University, 100 Kexue Road, Gaoxin district, Zhengzhou 450001, China
| | - Qingyun Xia
- Department of Health management, College of Public Health, Zhengzhou University, 100 Kexue Road, Gaoxin district, Zhengzhou 450001, China
| | - Yudong Miao
- Department of Health management, College of Public Health, Zhengzhou University, 100 Kexue Road, Gaoxin district, Zhengzhou 450001, China
| | - Chengcheng Yu
- Department of Health management, College of Public Health, Zhengzhou University, 100 Kexue Road, Gaoxin district, Zhengzhou 450001, China
| | - Clifford Silver Tarimo
- Department of Health management, College of Public Health, Zhengzhou University, 100 Kexue Road, Gaoxin district, Zhengzhou 450001, China
| | - Yinmei Yang
- Department of Health management, College of Public Health, Zhengzhou University, 100 Kexue Road, Gaoxin district, Zhengzhou 450001, China.
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Wu J, Shen Z, Li Q, Tarimo CS, Wang M, Gu J, Wei W, Zhang X, Huang Y, Ma M, Xu D, Ojangba T, Miao Y. How urban versus rural residency relates to COVID-19 vaccine hesitancy: A large-scale national Chinese study. Soc Sci Med 2023; 320:115695. [PMID: 36736053 PMCID: PMC9846885 DOI: 10.1016/j.socscimed.2023.115695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/08/2022] [Accepted: 01/16/2023] [Indexed: 01/19/2023]
Abstract
RATIONALE Although urban-rural residency has been shown to influence individual COVID-19 vaccine hesitancy, the differences between urban and rural China have yet to be uncovered. OBJECTIVE This study aims to assess the current prevalence and factors associated with COVID-19 vaccine hesitancy in urban and rural areas and explore whether the rural versus urban residency is associated with COVID-19 vaccine hesitancy. METHODS A national, cross-sectional, online survey among Chinese urban and rural adults (≥18 years old) was conducted from 6th to August 9, 2021. A questionnaire was used to collect data on sociodemographic factors, perceptions of the COVID-19 pandemic and vaccination status. A multivariable logistic regression model was used to identify the factors that influence COVID-19 vaccine hesitancy. Propensity score matching (PSM) analysis was performed to explore the association between urban versus rural residency and COVID-19 vaccine hesitancy. RESULTS In total, 29,925 participants (80.56% urban participants) were recruited. Urban participants had a higher COVID-19 vaccine hesitancy than their rural counterparts (9.39% vs. 4.26%). After adjusting for potential confounders, we found that COVID-19 vaccine hesitancy among females was lower than that in males in both urban (aOR = 0.78, 95% CI [0.69-0.88]) and rural areas (aOR = 0.54, 95% CI [0.39-0.75]). The lack of trust towards vaccine producers was found to be associated with vaccine hesitancy among the urban participants (aOR = 2.76, 95% CI [2.22-3.43]). The rural floating population had a lower COVID-19 vaccine hesitancy than the rural permanent residents (aOR = 0.58, 95% CI [0.42-0.80]). PSM analysis revealed a 2.38% difference in COVID-19 vaccine hesitancy between urban and rural participants. CONCLUSIONS Urban participants were more hesitant to receive the COVID-19 vaccine than rural participants. Priority should be placed on boosting confidence in the healthcare system to reduce COVID-19 vaccine hesitancy among urban residents. Furthermore, we advocate for extra incentives and vaccination education for rural permanent residents.
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Affiliation(s)
- Jian Wu
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, People's Republic of China; Henan Province Engineering, Research Center of Health Economy & Health Technology Assessment, Zhengzhou, Henan, People's Republic of China
| | - Zhanlei Shen
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, People's Republic of China; Henan Province Engineering, Research Center of Health Economy & Health Technology Assessment, Zhengzhou, Henan, People's Republic of China
| | - Quanman Li
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, People's Republic of China; Henan Province Engineering, Research Center of Health Economy & Health Technology Assessment, Zhengzhou, Henan, People's Republic of China
| | - Clifford Silver Tarimo
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, People's Republic of China; Henan Province Engineering, Research Center of Health Economy & Health Technology Assessment, Zhengzhou, Henan, People's Republic of China; Department of Science and Laboratory Technology, Dar es salaam Institute of Technology, Dar es Salaam, Tanzania
| | - Meiyun Wang
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan, People's Republic of China
| | - Jianqin Gu
- School of Medicine, Southern University of Science and Technology, Guangdong, People's Republic of China
| | - Wei Wei
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan, People's Republic of China
| | - Xinyu Zhang
- School of Public Health, Tianjin Medical University, Tianjin, People's Republic of China
| | - Yanli Huang
- Manage and service Center of Wuhou Medical Institutes, Sichuan, People's Republic of China
| | - Mingze Ma
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, People's Republic of China; Henan Province Engineering, Research Center of Health Economy & Health Technology Assessment, Zhengzhou, Henan, People's Republic of China
| | - Dongyang Xu
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, People's Republic of China; Henan Province Engineering, Research Center of Health Economy & Health Technology Assessment, Zhengzhou, Henan, People's Republic of China
| | - Theodora Ojangba
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, People's Republic of China; Henan Province Engineering, Research Center of Health Economy & Health Technology Assessment, Zhengzhou, Henan, People's Republic of China
| | - Yudong Miao
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, People's Republic of China; Henan Province Engineering, Research Center of Health Economy & Health Technology Assessment, Zhengzhou, Henan, People's Republic of China.
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Changes in COVID-19 Vaccine Acceptability among Parents with Children Aged 6-35 Months in China-Repeated Cross-Sectional Surveys in 2020 and 2021. Vaccines (Basel) 2023; 11:vaccines11010170. [PMID: 36680015 PMCID: PMC9867369 DOI: 10.3390/vaccines11010170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 01/15/2023] Open
Abstract
China is considering to offer COVID-19 vaccination for children aged 6−35 months. This study investigated the changes in COVID-19 vaccine acceptability and associated factors among parents with children aged 6−35 months in 2020 and 2021. Two rounds of cross-sectional online surveys were conducted among adult factory workers in Shenzhen, China. A subset of 208 (first round) and 229 (second round) parents with at least one child aged 6−35 months was included in the study. Parental acceptability of COVID-19 vaccination increased significantly from 66.8% in the first round to 79.5% in the second round (p = 0.01). Positive attitudes, perceived subjective norm, and perceived behavioral control were associated with higher parental acceptability in both rounds of surveys (p values ranged from <0.001 to 0.003). A negative association of negative attitudes with parental acceptability was observed in the second round (p = 0.02). No significant associations of exposure to information related to COVID-19 vaccination on social media with parental acceptability was found in either round of survey. Expanding the existing COVID-19 vaccination programs to cover children aged 6−35 months is necessary in China. Future programs should focus on modifying perceptions among parents to promote COVID-19 vaccination for children in this age group.
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Changes in Parents' COVID-19 Vaccine Hesitancy for Children Aged 3-17 Years before and after the Rollout of the National Childhood COVID-19 Vaccination Program in China: Repeated Cross-Sectional Surveys. Vaccines (Basel) 2022; 10:vaccines10091478. [PMID: 36146556 PMCID: PMC9502861 DOI: 10.3390/vaccines10091478] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/30/2022] [Accepted: 08/30/2022] [Indexed: 11/17/2022] Open
Abstract
China started to implement COVID-19 vaccination programs for children in July 2021. This study investigated the changes in parents’ COVID-19 vaccine hesitancy for children before and after the vaccination program rollout. Repeated cross-sectional online surveys among full-time adult factory workers were conducted in Shenzhen, China. This analysis was based on 844 (first round) and 1213 parents (second round) who had at least one child aged 3−17 years. The prevalence of vaccine hesitancy for children aged 3−11 years dropped from 25.9% (first round) to 17.4% (second round), while such a prevalence for children aged 12−17 years dropped from 26.0% (first round) to 3.5% (second round) (p < 0.001). Positive attitudes, a perceived subjective norm, and perceived behavioral control related to children’s COVID-19 vaccination were associated with lower vaccine hesitancy in both rounds. In the second round and among parents with children aged 3−11 years, negative attitudes and exposure to information on SARS-CoV-2 infection after receiving a primary vaccine series were associated with higher vaccine hesitancy, while exposure to experiences shared by vaccine recipients and infectiousness of variants of concern were associated with lower vaccine hesitancy. Regular monitoring of vaccine hesitancy and its associated factors among parents should be conducted to guide health promotion.
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Jiang N, Yang C, Yu W, Luo L, Tan X, Yang L. Changes of COVID-19 Knowledge, Attitudes, Practices and Vaccination Willingness Among Residents in Jinan, China. Front Public Health 2022; 10:917364. [PMID: 35669759 PMCID: PMC9163493 DOI: 10.3389/fpubh.2022.917364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 04/27/2022] [Indexed: 11/13/2022] Open
Abstract
Background Vaccine hesitancy is responsible for low vaccine coverage and increased risk of epidemics. The purpose of this study was to assess whether public knowledge, attitudes, practices, and willingness to vaccinate against COVID-19 have changed over time and at different stages of vaccination. Methods Two consecutive surveys were conducted among residents of the Leshan Community in Jinan from May to June, 2021 (n = 423) (basic dose vaccination phase) and from December, 2021 to January, 2022 (n = 470) (booster vaccination phase). Randomly sampling was used in residents to complete an anonymous questionnaire. Chi-square test was used to compare the changes in knowledge, attitudes and practices of the subjects in different survey stages. Multivariable logistic regression analysis was used to explore factors related to vaccination hesitancy. Results In the booster vaccination phase, protective behaviors (89.9%) of residents increased significantly compared with the basic vaccination phase (74.5%). Residents were more hesitant to receive booster doses than basal doses of COVID-19 vaccine (OR: 18.334, 95% CI: 9.021-37.262). Residents with other marital statuses (OR: 2.719, 95% CI: 1.632-4.528), negative attitudes toward government measures were more hesitant to get vaccinated (OR: 2.576, 95% CI: 1.612-4.118). People who thought their physical condition was very good or good were more likely to be vaccinated than those who thought they were in fair or poor health (OR: 0.516, 95% CI: 0.288-0.925; OR: 0.513, 95% CI: 0.295-0.893). Young people inclined to use new media (such as WeChat and microblog) to obtain information, while the elderly inclined to use traditional methods (such as television). Government propaganda, residents' perception of the importance of vaccines and the risk of disease were the main reasons for accelerating residents to vaccinate. The main reasons affecting residents' lack of vaccination were contraindications to the vaccine or inconvenient time for vaccination. Conclusions Vaccine hesitancy increased significantly with change in vaccination stage. Strategies should be adopted to increase vaccination coverage such as improving the convenience of vaccination, promoting through multiple channels.
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Affiliation(s)
- Ning Jiang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Cheng Yang
- Department of Project Office, Shandong Anke Blockchain Industrial Development Institute, Jinan, China
| | - Wenjing Yu
- Department of Project Office, Shandong Anke Blockchain Industrial Development Institute, Jinan, China
| | - Liyan Luo
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xin Tan
- Leshan Community, Jinan, China
| | - Liping Yang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
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Liu Y, Ma Q, Liu H, Guo Z. Public attitudes and influencing factors toward COVID-19 vaccination for adolescents/children: a scoping review. Public Health 2022; 205:169-181. [PMID: 35303534 PMCID: PMC8825307 DOI: 10.1016/j.puhe.2022.02.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 01/30/2022] [Accepted: 02/01/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE This study aimed to systematically clarify attitudes and influencing factors of the public toward COVID-19 vaccination for children or adolescents. STUDY DESIGN This was a scoping review. METHODS This scoping review screened, included, sorted, and analyzed relevant studies on COVID-19 vaccination for children or adolescents before December 31, 2021, in databases, including PubMed, Elsevier, Web of Science, Cochrane Library, and Wiley. RESULTS A total of 34 studies were included. The results showed that the public's acceptance rate toward COVID-19 vaccination for children or adolescents ranged from 4.9% (southeast Nigerian mothers) to 91% (Brazilian parents). Parents' or adolescents' age, gender, education level, and cognition and behavior characteristics for the vaccines were the central factors affecting vaccination. The vaccine's safety, effectiveness, and potential side-effects were the main reasons affecting vaccination. CONCLUSIONS Realizing current public attitudes of COVID-19 vaccination for adolescents or children can effectively develop intervention measures and control the pandemic as soon as possible through herd immunity.
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Affiliation(s)
- Y Liu
- School of Nursing, University of South China, Hengyang, China
| | - Q Ma
- School of Nursing, University of South China, Hengyang, China
| | - H Liu
- School of Nursing, University of South China, Hengyang, China
| | - Z Guo
- School of Nursing, University of South China, Hengyang, China; Institute of Pharmacy and Pharmacology, University of South China, Hengyang, China.
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Evaluating COVID-19 Vaccine Willingness and Hesitancy among Parents of Children Aged 5–11 Years with Chronic Conditions in Italy. Vaccines (Basel) 2022; 10:vaccines10030396. [PMID: 35335028 PMCID: PMC8953590 DOI: 10.3390/vaccines10030396] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 02/24/2022] [Accepted: 03/01/2022] [Indexed: 02/01/2023] Open
Abstract
COVID-19 vaccination has been extended to include children aged 5–11 years. This cross-sectional survey evaluated parental COVID-19 vaccine willingness and hesitancy, and associated factors, for their children aged 5–11 years with chronic conditions. A telephone survey was conducted from 14 December 2021 to 4 January 2022. The questionnaire assessed participants’ socio-demographic and health-related information, attitudes towards COVID-19 infection, hesitancy, by using the PACV-5 (Parent Attitudes About Childhood Vaccines Survey Tool), and sources of information. A total of 430 answers were collected anonymously. Respondents with no cohabitant who had been infected by SARS-CoV-2 and having been vaccinated against COVID-19 had a higher concern about the severity of COVID-19. The parents’ perceived risk that the child could be infected by SARS-CoV-2 was higher in those more concerned about the severity of COVID-19, with an older child, and who had at least one cohabitant positive for COVID-19. Only 38.8% parents were willing to vaccinate their children against COVID-19. Parents who did not need additional information, those with higher education, those who have been vaccinated against COVID-19, those whose child was older, who had received information on this vaccination from physicians, with higher self-reported concern about the severity of COVID-19, and who had a higher perceived risk that their child could be infected by SARS-CoV-2, expressed a greater willingness to vaccinate their child. Overall, 26.3% were high-hesitant, with a PACV-5 score ≥ 7. Respondents who did not get the COVID-19 vaccine, were less educated, with a lower concern about severity of COVID-19, and with a lower perceived risk that their child could be infected by SARS-CoV-2, were more likely to be high-hesitant. New policies and educational programs regarding COVID-19 vaccination for children with chronic conditions are needed to reduce hesitancy and increase vaccination uptake.
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