Sociodemographic differences in parental hesitancy to the COVID-19 vaccine

To identify sociodemographic patterns in pediatric COVID-19 vaccination status and parental vaccine hesitancy reasons.

Cross-sectional survey data was collected from 5103 US parents of 6 month to 17-year-olds from the NIH Environmental influences on Child Health Outcomes (ECHO) study. We used chi-square tests to examine sociodemographic differences between vaccinated and unvaccinated children and between vaccine-hesitant and non-hesitant parents. We used risk ratios (RRs) from adjusted multivariable Poisson regressions to examine associations between sociodemographic characteristics and vaccine hesitancy reasons.

Less than half (41.7 %) of children had received at least one dose of the COVID-19 vaccine. Only 1 % of parents who were unsure or had no plans to vaccinate their children ("vaccine hesitant") cited resource barriers (e.g., transportation, cost). Instead, vaccine-hesitant parents reported concerns about side effects (general: 53.1 %; long-term: 56.2 %); believed their child did not need the vaccine due to low risk (33.7 %) or prior infection (21 %); perceived there was insufficient vaccine testing in children (24 %) and in racially/ethnically diverse populations (9.5 %); and lacked trust in healthcare provider recommendations (9 %). Vaccine-hesitant parents of Indigenous and Black children were less likely to report side effect concerns (general: RR 0.65-0.87; long-term: RR 0.55-0.66); higher-income and higher-educated vaccine-hesitant parents were ∼ 1.5-2 times more likely to say their child was at low risk.

Safety concerns and perceived low risk influenced parental COVID-19 vaccination hesitancy, not resource barriers. Important sociodemographic differences can inform future approaches to public health campaigns to propel swift action during a public health crisis to help reduce disease burden and spread.