Parental vaccine hesitancy and immunization practices in children with food allergy

The objective is to assess vaccine hesitancy among parents of children with food allergy compared with parents of healthy children, and to examine immunization practices in this population. In this cross-sectional analytic study conducted between March and October 2025, parents of children aged 0-36 months with food allergy completed a validated Vaccine Hesitancy Scale (VHS) in their native language. Vaccine hesitancy subscales-including perceived benefits and protective value of vaccination, anti-vaccine attitudes, non-vaccination strategies, and legitimization of hesitancy-along with immunization practices were compared with healthy controls. The study included 250 children with food allergies and 250 healthy controls. Total VHS scores were similar between groups (42.8 ± 15.4 vs 41.5 ± 14.0, p = 0.54). However, subscale scores for "strategies for non-vaccination" and "legitimization of vaccine hesitancy" were significantly higher among parents of children with food allergies. The rate of delayed or incomplete vaccination was significantly higher in children with food allergies (25 vs 4, p < 0.001), particularly for the measles-mumps-rubella vaccine among children with egg allergies.

The total VHS scores between parents of FA and healthy controls were similar, indicating that parents of children with food allergy do not exhibit a distinct or heightened level of VH. However, even if it does not reflect in the total scores, due to the higher scores in subscales of "strategies to avoid vaccination" and "legitimization of vaccine hesitancy," parents of children with FA should be evaluated carefully to promote vaccination in their children.

• Childhood vaccine hesitancy and refusal are a secular trend affecting both the healthy population and individuals with chronic diseases.

• Children with food allergies are at increased risk of under-vaccination, particularly for the MMR vaccine, but this situation is not directly associated with parental vaccine hesitancy.