Parents’ Decisions to Vaccinate Children against COVID-19: A Scoping Review

Since 2019, the COVID-19 pandemic has resulted in sickness, hospitalizations, and deaths of the old and young and impacted global social and economy activities. Vaccination is one of the most important and efficient ways to protect against the COVID-19 virus. In a review of the literature on parents’ decisions to vaccinate their children, we found that widespread vaccination was hampered by vaccine hesitancy, especially for children who play an important role in the coronavirus transmission in both family and school. To analyze parent vaccination decision-making for children, our review of the literature on parent attitudes to vaccinating children, identified the objective and subjective influencing factors in their vaccination decision. We found that the median rate of parents vaccinating their children against COVID-19 was 59.3% (IQR 48.60~73.90%). The factors influencing parents’ attitudes towards child vaccination were heterogeneous, reflecting country-specific factors, but also displaying some similar trends across countries, such as the education level of parents. The leading reason in the child vaccination decision was to protect children, family and others; and the fear of side effects and safety was the most important reason in not vaccinating children. Our study informs government and health officials about appropriate vaccination policies and measures to improve the vaccination rate of children and makes specific recommendations on enhancing child vaccinate rates.

Parent Attitudes about Childhood Vaccines: Point Prevalence Survey of Vaccine Hesitancy in an Irish Population

Understanding parental attitudes to their children’s vaccination is critical to developing and implementing interventions that address parents’ hesitancy and improve vaccine uptake. The Parent Attitudes about Childhood Vaccines (PACV) survey is a validated tool for identifying vaccine hesitancy in parents. We evaluated the rate of vaccine hesitancy and areas of concern regarding childhood vaccinations using an adapted version of the PACV survey, in a convenience sample of parents attending a STEM (Science, Technology, Engineering and Mathematics) outreach event in Ireland, in 2018. A score ≥ 50 identified vaccine hesitant parents. Of 105 parents who completed the survey, the prevalence of vaccine hesitancy was 6.7%, (7/105). Parents had concerns around vaccine side effects (36.2%, n = 38), vaccine safety (20%, n = 21) and the number of vaccines administered (13.3%, n = 14). Parents trusted the vaccine information they received (85.6%, n = 90) and 81.9% (n = 86) believed that the vaccine schedule was good for their child. The findings indicate the presence of vaccine hesitancy in parents in Ireland regarding paediatric vaccines with further research necessary to address parents’ vaccine concerns. Future research should explore further, by qualitative methods, parents’ vaccine concerns. There is also potential to identify vaccine hesitant parents with the PACV survey as a surveillance method in healthcare settings; for example, in community pharmacies, family doctor clinics and out-patient clinics.

1172. SARS-CoV-2 Vaccine Hesitancy in Caregivers of Hospitalized Children

Background SARS-CoV-2 vaccine hesitancy (VH) is hindering nationwide vaccination efforts; little is known about caregiver SARS-CoV-2 vaccine acceptance for children. We aimed to identify associations with SARS-CoV-2 VH in caregivers of hospitalized children. Methods We conducted a prospective cross-sectional survey in English and Spanish of caregiver COVID-19 knowledge, attitudes, behaviors, and associated VH among hospitalized children 6 months - 18 years at a large pediatric medical institution. Parents were approached daily, averaging 4-5 days/week, from 12/8/2020--4/5/2021. VH was assessed using the Parent Attitudes about Childhood Vaccines (PACV) survey; PACV score ≥50 denoted VH. Descriptive statistics and multivariable logistic regression were used. Responses were categorized. Results 295/307 (96%) of approached caregivers enrolled; 79% were ≥ 30 years, 68% were married/ living with a partner, and 57% had at least some college. 36% identified as white, 19% Black, and 46% Hispanic/ Latino. 53% of caregiver children had public insurance. 91% of caregivers self-reported their children were up to date with routine vaccines. 17% of caregivers were vaccine-hesitant overall. 50% of caregivers were willing to receive COVID-19 vaccine themselves. Figure 1 shows intention to vaccinate their child by PACV score. 65% knew someone who was hospitalized for COVID-19. 67% were scared of their child getting COVID-19. However, 49% were scared of their child getting the vaccine, 28% did not want to vaccinate their child and 27% were neutral in the intention to vaccinate their child. Caregivers who did not intend to vaccinate their child were more likely to be Black (27% vs. 16%, p=0.04) and less likely to be Hispanic/ Latino (33% vs. 49%, p=0.02). Table 1 shows attitudes, beliefs, and behaviors surrounding the COVID-19 pandemic and vaccine in caregivers who did or did not intend to vaccinate their child. Figure 1 COVID-19 vaccine uptake by PACV score Table 1 Caregiver attitudes, beliefs, and behaviors surrounding the COVID-19 pandemic and the COVID-19 vaccine Conclusion The majority of caregivers believe that SARS-CoV-2 vaccine will help control the pandemic, but less than half plan to vaccinate their children. A quarter of caregivers expressed uncertainty regarding the vaccine and therefore may be amenable to education and discussion. COVID-19 VH is different from VH towards routine vaccinations. More research is needed to address COVID-19 specific VH. Disclosures C. Mary Healy, MD, Dexcom (Shareholder)Intuitive (Shareholder)Quidel Corporation (Shareholder)Up to Date (Other Financial or Material Support, Honorarium)Vapotherm (Shareholder)

Parent attitudes about childhood vaccines: a vaccine hesitancy point prevalence study.

Objectives The aim of this study was to measure the prevalence of vaccine hesitancy using Parent Attitudes about Childhood Vaccines (PACV) survey regarding paediatric vaccines for their children, in a population of parents attending a STEM (Science, Technology, Engineering and Mathematics) outreach event in Cork, Ireland. Study design Cross-sectional survey study. Methods This study was conducted in November 2018 at the Community Festival of Science STEM event. Eligible attendees were invited to read the participant information leaflet, provide written informed consent, and complete the validated Parent Attitudes about Childhood Vaccines (PACV) survey. Each of the 15 PACV survey items was scored. A score ≥50 identified vaccine hesitant parents. Results A total of 105 parents participated in the study. A small number of participants (6.7%, n = 7) were identified as vaccine hesitant. There were no statistically significant differences between the vaccine hesitant and non-hesitant groups based on age, education, or number of children. Parents had concerns around vaccine side effects (36.2%, n=38) and vaccine safety (20%, n=21). Parents trusted the information they received on vaccines (85.6%, n=90) and 81.9% (n=86) believed that the vaccine schedule was good for their child. Conclusions The findings of this research indicate the presence of vaccine hesitancy in parents in Ireland regarding paediatric vaccines. Parents had concerns regarding vaccine side effects and the number of vaccines on the paediatric immunisation schedule. Further research is necessary to understand how these issues may contribute to vaccine hesitancy, and to develop evidence-based interventions to build on parents existing trust in the vaccination schedule.

Parent Attitudes Towards the Integration of Digital Learning Games as an Alternative to Traditional Homework

The COVID-19 pandemic caused children to distance learn at home, but with technical and pedagogic difficulties. Digital learning games offer effective tools for pedagogic difficulties, such as active and relevant learning. Using mixed-methods research, this study examined 1) parents' perceptions about digital learning games and 21st century skills and 2) parents' attitudes towards digital learning games instead of traditional homework. The findings are based on both qualitative (in-depth interviews) and quantitative (online survey) data. The results of the study revealed that parents do not object to replacing traditional homework with digital learning games. They saw digital learning games as relevant for their children's digital lives and acknowledged their potential to reduce arguments over homework. Therefore, digital learning games should be employed in school and as an alternative for traditional homework, both in routine and crisis, such as the COVID-19 pandemic.

The referral of Pakistani immigrant children for special education in Toronto : perceptions and attitudes of parents

This study examines the perceptions of Pakistani immigrant parents regarding the referral of their children to special education programs in Toronto. The study is qualitative and is based on the grounded theory method. Interviews were conducted by the author with five parent participants and were transcribed and coded. This research provided insight into the perceptions of Pakistani immigrant parents whose children (8-12 years) are in special needs classes. Also included in the data is an interview the author conducted with a Pakistani parent who is also working as a special needs assistant in the Toronto District School Board (TDSB). The findings of the study indicate that there are five main reasons behind the referral of Pakistani immigrant children for special education: 1) parent attitudes; 2) cultural and linguistic differences; 3) teacher attitudes; 4) peer attitudes; and 5) immigration. The results indicate that there is an over-referral of Pakistani immigrant children [in Toronto schools] according to Pakistani parents' perceptions. Recommendations are made for implementing change within the special education system in the TDSB and areas for future research are identified.