Parental Vaccine Hesitancy, Trust in Physicians, and Future Vaccination Intentions: A PACV Cross-Sectional Study

Parents' vaccine hesitancy constitutes a global challenge, strongly associated with trust in healthcare professionals. This study aimed to identify socio-demographic predictors of parental pro- and anti-vaccination behaviors and investigate the association between these factors and intentions regarding children's future immunizations.

We conducted a cross-sectional online survey using the Parent Attitudes about Childhood Vaccines (PACV) questionnaire. Participants were recruited purposively and via snowballing through parenting groups and educational institutions.

We surveyed 1.046 parents and provided attitudes for 1.701 children; 85.1% of child-specific responses reflected positive attitudes (PACV ≤ 50; median 16.7). In univariate regression, employment (OR = 2.172, 95% CI: 1.530-3.084; p < 0.001) and healthcare employment (OR = 2.907, 95% CI: 1.983-4.262; p < 0.001) increased the odds of positive attitudes, whereas each additional household member (OR = 0.693, 95% CI: 0.597-0.805; p < 0.001) and child (OR = 0.677, 95% CI: 0.579-0.792; p < 0.001) reduced them. Multivariable models confirmed higher odds for suburban/rural residence (OR = 1.614, 95% CI: 1.037-2.513; p = 0.034), employment (OR = 1.869, 95% CI: 1.284-2.721; p = 0.001), and healthcare employment (OR = 2.785, 95% CI: 1.872-4.144; p < 0.001). Among prior non-vaccinators (n = 114), 39.5% planned to vaccinate, 41.2% did not. Those who planned showed greater trust than non-planners in the child's doctor (mean: 7.49 vs. 3.74) and schedule (mean: 7.89 vs. 1.40), p < 0.001, with lower trust correlating with greater hesitancy and safety concerns.

Trust in physicians was strongly associated with both current attitudes and future intentions. Trust-focused, patient-centered communication may be related to more positive vaccination attitudes among parents. However, longitudinal research is needed to determine whether such trust could influence changes in vaccination behavior, especially since parents' attitudes toward vaccinations can evolve with the arrival of subsequent children.