Exploring Parent-Driven Determinants of COVID-19 Vaccination in Indigenous Children: Insights from a National Survey

Background: Globally and in Canada, Indigenous populations have faced heightened vulnerability during pandemics, with historical inequities exacerbated by multigenerational colonial policies. This study aimed to identify parental factors influencing COVID-19 vaccination among Indigenous children in Canada. Methods: Data from a nationally representative, cross-sectional survey of parents/guardians with children under 18 years of age were analyzed. The study focused on Indigenous children, examining vaccine uptake, parental hesitancy, and related sociodemographic factors. Multivariable logistic regression models were employed to identify key predictors of COVID-19 vaccination. Results: COVID-19 vaccine coverage among Indigenous children was 61.8%, with higher uptake among Inuit (74.4%) children compared to Métis (61.2%) and First Nations (59.6%) children. Nearly half of Indigenous parents (53.4%) expressed hesitancy, primarily due to perceived concerns about insufficient research on the vaccine in children. Higher vaccine uptake was associated with parental education, adherence to routine vaccinations, and urban residence. Conversely, parental hesitancy, particularly related to medical concerns, significantly decreased the likelihood of vaccine uptake. Conclusions: The study highlights the complexity of vaccine hesitancy among Indigenous parents. Targeted interventions, including culturally adapted educational initiatives, community engagement, and healthcare provider advocacy, are essential to improve vaccine uptake.