Parental coronavirus disease vaccine hesitancy for children in Bangladesh: a cross-sectional study

Systematic review: Impact of parental decision on paediatric COVID-19 vaccination

OBJECTIVE

The objective was to carry out a systematic review on the acceptance of parents to vaccinate their children against COVID-19 and the factors that contribute for vaccination hesitancy.

METHODS

The Preferred Reporting Items for Systematic Re- views and Meta-Analyses (PRISMA) guidelines and the Patient, Intervention, Comparison and Outcome (PICO) strategy were followed. A search was carried out in the VHL Regional Portal, PubMed, Scielo, Web of Science, Embase and Scopus databases. We included articles that assessed the rate of acceptance and/or hesitation of parents and the factors that affect the decision about vaccination against COVID-19 for their children in cross-sectional studies. Laboratory studies, animal models, tests and case reports that elected other aspects related to COVID-19 were excluded. The methodological quality of the studies was based on the JBI Critical Appraisal Checklist for Studies Reporting Prevalence Data, developed by the Joanna Briggs Institute.

RESULTS

From the 708 articles found, 237 studies remained after removal of duplicates. Titles and abstracts of these publications were evaluated and, applying the exclusion criteria, 56 articles were selected. Inclusion criteria were employed and 28 studies were eligible. Overall average vaccination acceptance rate was 55.81%, and the main reasons for vaccine hesitancy were uncertainty of vaccine efficacy and safety, concerns about side effects, and lack of access to relevant information.

CONCLUSION

The research results can be useful for the development of health education and parental awareness strategies in order to promote greater adherence to vaccination against COVID-19.

COVID-19 vaccine hesitancy among parents in Low- and Middle-Income Countries: A meta-analysis

Background

Vaccination is the most effective method to prevent the spread of infectious diseases. Nevertheless, vaccine hesitancy has been an issue. Parental hesitancy toward vaccines is a major part of the problem. COVID-19 vaccine acceptance is no different, it poses another challenge in facing the pandemic. In Low- and Middle-Income Countries (L&MICs) several studies measured parents' acceptance to vaccinate their children against COVID-19 and resulted in different acceptance proportions.

Aims

The paper aims at obtaining a precise estimate of the overall proportion of L&MICs' parents accepting to vaccinate their children against COVID-19 and identifying the main determinant of their decisions.

Methods

This meta-analysis follows the PRISMA 2020 statement on updated guidelines and the checklist for reporting systematic reviews. Studies published between December till February 2022 were assessed for inclusion. The final effect size (i.e., the proportion of parents in L&MICs accepting to vaccinate their children against COVID-19) was measured using the Arcsine proportions method. Analysis was done using R program.

Results

The proportion of parents in L&MICs accepting to vaccinate their children against COVID-19 is 49%. The major reason for their acceptance is their belief that COVID-19 vaccine is fundamental to the fight against the pandemic while the most common factor for parents' hesitancy to vaccinate their children against COVID-19 is their concerns about vaccine efficacy, safety, and possible side effects.

Conclusion

The proportion of parents in L&MICs accepting to vaccinate their children against COVID-19 is lower than the global level. To increase parental acceptance, responsible authorities should concentrate on increasing their population's trust in the government and in vaccine manufacturers. As well as concentrating on increasing acceptance of the vaccine idea in general.

Parental COVID-19 vaccination hesitancy among parents of children aged 5-18 years in Thailand: a cross-sectional survey study

BACKGROUND

To promote an acceptance rate of COVID-19 immunization among Thai children, concerns about parental vaccination hesitancy should be urgently studied. This study aimed to examine the parental COVID-19 vaccination hesitancy (PVh) level and influencing factors among Thai parents of children 5-18 years of age.

METHODS

This cross-sectional survey was conducted in Thailand during May and June of 2022. The Google forms for data collection were distributed to parents (a father, a mother, or one who nurtures and raises a child) via various online social media. Data regarding PVh level, relevant attitudes, experiences of COVID-19 and COVID-19 vaccination (EC&V), and family contexts (FC) were collected and analyzed using descriptive statistics. Mann-Whitney U test was used to compare the differences among groups of parents based on EC&V and FC. The factors influencing PVh were assessed by multiple regression analysis.

RESULTS

Four hundred and eighty-eight parents completed the online questionnaire. Their median (IQR) age was 41 (35-47) years. They lived in different provinces from all regions across Thailand. Ninety percent of them were authorized persons to make decision about children vaccination. Fifty-eight percent of the respondents had vaccine hesitancy, defined as PVh level at moderate or above. Parents who had ever refused COVID-19 vaccination for themselves or refused to vaccinate their children against any other diseases had statistically significant higher levels of PVh (p value < 0.001). Conversely, the parents who had finished the initial COVID-19 vaccine had lower PVh levels with statistical significance (p value = 0.001). Attitude towards COVID-19 (AC), attitude towards COVID-19 vaccine (AV), and perceived behavioral control (PC) of the parents negatively influenced PVh with statistical significance, according to the results of the multiple regression analysis (Betas = - 0.307, - 0.123, and - 0.232, respectively).

CONCLUSIONS

COVID-19 vaccination hesitancy was commonly found among Thai parents. The factors of the hesitancy were multifaceted. Different experiences regarding COVID-19 vaccination for themselves and any vaccinations for their children were associated with different PVhs. The attitudes especially AC, AV, and PC statistically influenced PVh. These findings should be exploited for national and local policy planning as well as public campaigns.

What is driving unwillingness to receive the COVID-19 vaccine in adult Bangladeshi after one year of vaccine rollout? Analysis of observational data

Objective

The present study aimed to (1) assess the prevalence of COVID-19 vaccine unwillingness and (2) identify the factors associated with vaccine unwillingness.

Methods

This cross-sectional study analyzed data of 2633 Bangladeshi adults. Descriptive analysis was performed to compute the prevalence of vaccine unwillingness by the participants' sociodemographic characteristics. Multiple logistic regression analyses were performed to compute Adjusted Odds Ratios (AORs) with vaccine unwillingness as a dependent variable and sociodemographic characteristics as predictor variables for vaccine unwillingness.

Results

Overall, 27.4% respondents showed unwillingness to receive the COVID-19 vaccine. Regression model suggested that groups with significantly higher odds of vaccine unwillingness were found to be participants aged 18-25 years (AOR= 3.41, CI= 1.71-6.80), Muslim (AOR= 1.81, CI= 1.21-2.71), participants with higher secondary education (AOR= 3.12, CI= 1.73-5.63), unemployed (AOR= 8.79, CI= 5.42-14.26), participants with monthly household income < □ 15000 (AOR= 4.03, CI= 2.51-6.47), residents of a semi-urban setting (AOR= 1.43, CI= 1.01-2.03), participants affiliated with opposition parties (AOR= 2.82, CI= 1.89-4.21), and participants who did not report that they or their family members tested positive for COVID-19 (AOR= 4.32, CI= 3.08-6.07).

Conclusion

The study findings suggested that a certain vaccine literacy campaign targeting semi-urban, low-income, and low-educated Bangladeshi is warranted to ensure the widespread uptake of COVID-19 vaccines in Bangladesh.

Parents' Hesitancy to Vaccinate Their Children Against COVID-19, a Country-Wide Survey

Objective

Parents' hesitancy (PH) toward childhood vaccination, including the vaccine of coronavirus disease (COVID-19), is one of the top public health threats. We aim to assess the PH toward children COVID-19 vaccination as compared to PH toward children routine vaccination among the residents of Saudi Arabia.

Method

Before the official approval of children's COVID-19 vaccination in the country, a cross-sectional study using an electronically distributed survey was performed. Responses from parents of children younger than 18 years of age were accepted. The Oxford COVID-19 vaccine hesitancy scale (OC19-VHS) and the routine vaccination hesitancy scale (R-VHS) were used. Parents were classified as hesitant, non-hesitant, and unsure.

Results

Between June 18th-30th, 2021, we included 1,052 parents. More than half of the parents were positive toward the childhood COVID-19 vaccination (63%) while 10% were unsure. Higher parental hesitancy toward children COVID-19 vaccination among mothers, parents younger than 40 years, did not receive COVID-19 nor influenza vaccines, had higher educational levels, and parents who recovered from COVID-19 infection. Hesitancy was mainly driven by the novelty of the vaccines and the fear of serious adverse effects. Compared to the routine vaccination, parents were more hesitant toward COVID-19 vaccination (6 vs. 27%).

Conclusion

Generally, parents in Saudi Arabia were positive toward children's COVID-19 vaccination. Focused education to reassure hesitant parents on the safety of the vaccine is essential to achieve larger vaccination coverage.

Parents' Hesitancy to Vaccinate Their 5-11-Year-Old Children Against COVID-19 in Saudi Arabia: Predictors From the Health Belief Model

Data exploring parents' hesitancy to vaccinate their 5–11-year-old children against COVID-19, and associated factors, is limited. This study aims to investigate parents' beliefs and intentions to vaccinate their 5–11-year-old children using the Health Belief Model in Saudi Arabia. A national, cross-sectional, questionnaire-based study was conducted in November, 2021. The self-administered online questionnaire was distributed to a random sample of parents. Adult parents with at least one 5–11-year-old child were included. The main outcome was parents' intention to vaccinate their 5–11-year-old children. Variability in parents' intention was assessed by demographics, COVID-19-related factors, children's health status, and constructs from the Health Belief Model. Univariate and multivariable logistic regression were used to investigate each factor and adjust for the intervariable effect on parental intention to vaccinate their children. Of the 4,135 participants, 61.9% were hesitant to vaccinate their 5–11-year-old children. Parents aged 31 to 40 years (OR = 1.23; 95% CI, 1.02–1.49) and females (OR = 1.52; 95% CI, 1.25–1.84) had higher odds of being hesitant to vaccinate their children than parents from other groups. Parents who perceived low benefit from the vaccine (OR = 16.3; 95% CI, 12.1–21.9) or who had safety or efficacy concerns (OR = 3.76; 95% CI, 3.10–4.58) were among the most hesitant to vaccinate their children. In conclusion, vaccine hesitancy is prevalent among parents of 5–11-year-old children in Saudi Arabia and those who had beliefs of minimal benefits or lack of safety from the COVID-19 vaccine were more hesitant. Government efforts must be directed toward increasing parents' vaccine awareness and tackling the constructs of the Health Belief Model through a well-designed vaccination campaign.

Parental COVID-19 vaccine hesitancy for children with neurodevelopmental disorders: a cross-sectional survey

Background

Little is known about parental coronavirus disease 2019 (COVID-19) vaccine hesitancy in children with neurodevelopmental disorders (NDD). This survey estimated the prevalence and predictive factors of vaccine hesitancy among parents of children with NDD.

Methods

A nationally representative cross-sectional survey was conducted from October 10 to 31, 2021. A structured vaccine hesitancy questionnaire was used to collect data from parents aged ≥ 18 years with children with NDD. In addition, individual face-to-face interviews were conducted at randomly selected places throughout Bangladesh. Multiple logistic regression analysis was conducted to identify the predictors of vaccine hesitancy.

Results

A total of 396 parents participated in the study. Of these, 169 (42.7%) parents were hesitant to vaccinate their children. Higher odds of vaccine hesitancy were found among parents who lived in the northern zone (AOR = 17.15, 95% CI = 5.86–50.09; p < 0.001), those who thought vaccines would not be safe and effective for Bangladeshi children (AOR = 3.22, 95% CI = 1.68–15.19; p < 0.001), those who were either not vaccinated or did not receive the COVID-19 vaccine themselves (AOR = 12.14, 95% CI = 8.48–17.36; p < 0.001), those who said that they or their family members had not tested positive for COVID-19 (AOR = 2.13, 95% CI = 1.07–4.25), and those who did not lose a family member to COVID-19 (AOR = 2.12, 95% CI = 1.03–4.61; p = 0.040). Furthermore, parents who were not likely to believe that their children or a family member could be infected with COVID-19 the following year (AOR = 4.99, 95% CI = 1.81–13.77; p < 0.001) and who were not concerned at all about their children or a family member being infected the following year (AOR = 2.34, 95% CI = 1.65–8.37; p = 0.043) had significantly higher odds of COVID-19 vaccine hesitancy.

Conclusions

Given the high prevalence of vaccine hesitancy, policymakers, public health practitioners, and pediatricians can implement and support strategies to ensure that children with NDD and their caregivers and family members receive the COVID-19 vaccine to fight pandemic induced hazards.