Parental Perception and Barriers Regarding COVID-19 Vaccination in Technology Dependent Children

Children who use chronic home mechanical ventilation are at high risk for respiratory infections and mortality. They are also at increased risk for developing severe COVID-19 infection. The primary goal of this study was to evaluate the parental perception of the COVID-19 vaccine in pediatric patients with technology dependence.

We conducted a cross-sectional survey at a children's hospital between September 2021 and February 2022. A telephone or in-person interview was conducted to assesss parental attitudes toward the COVID-19 vaccine for their technology-dependent child. Technology-dependent groups included patients requiring (1) invasive mechanical ventilation via tracheostomy and (2) noninvasive mechanical ventilation via a facial interface.

Fourteen of 44 participants (32%) of technology-dependent children were vaccinated for COVID-19 despite high parental vaccination and influenza vaccination rates. Twenty-eight patients (63% of total participants) were tracheostomy dependent. In the tracheostomy group, the COVID-19 vaccine rate was 28% versus 54% in the nontracheostomy group.  Concern for vaccine side effects was the major reason for vaccine hesitancy (53%). More parents of vaccinated children than unvaccinated children were counseled by their primary care provider (85.7% vs. 46.7%; p = .02) or subspecialist (93% vs. 47%; p = .003).

Our findings suggest counseling by primary care providers and subspecialists is important in overcoming COVID-19 vaccine hesitancy. Social media was identified as a major source of information, particularly among parents of unvaccinated patients.