Parents’ concerns about safety of childhood vaccines increased during pandemic

Anisha Abraham, MD

The COVID-19 pandemic caused a decrease in well-child visits and vaccinations in the United States. Parental hesitancy for pediatric COVID-19 vaccines and widespread vaccine misinformation during the pandemic may have affected parental confidence in routine childhood vaccines. Until now, there have been few studies on this issue.

The study in Pediatrics used longitudinal data from a nationally representative sample to determine how parents’ confidence in childhood vaccines changed during the pandemic. Researchers analyzed data from the Understanding America Study. Nearly 9,500 participants were enrolled via the internet using address-based sampling. Surveys were distributed twice a week from spring 2020 to winter 2021, then monthly through the summer of 2021. Additional surveys were also given in the fall of 2021 and winter of 2022. Participants were asked if they agreed with four statements about childhood vaccines. Researchers examined trends in the percentage of parents who strongly agreed or agreed with each statement.

From April 2020 to March 2022, the percentage of parents who agreed with the “important benefits” and “useful and effective” statements remained stable and high, ranging from 89.5% to 92.5% and from 89.3% to 93.2%, respectively. By contrast, the percentage of parents who agreed with the illness or death and harmful side effects statements increased significantly by 13.2 percentage points. In this national sample, the proportion of parents concerned about the safety and side effects of routine childhood vaccines increased significantly between April 2020 and March 2022, although parental confidence in the benefits and effectiveness of childhood vaccines remained high.

Limitations of this study include the generalizability of online data and insufficient sample sizes for certain racial and ethnic groups. However, the study findings highlight the important role of pediatricians in addressing parents’ concerns about childhood vaccines and hesitancy.

Diego R Hijano, MD, MSc

As we approach 3 years since SARS-CoV-2 was first detected, we continue to learn about its deleterious impact on our lives. Global orphanhood, decreased life expectancy and increased disparities in health access and outcomes continue to stun us. This month in Pediatrics, Shah and colleagues have been able to quantify the magnitude of one of the most meaningful impacts of the pandemic: decrease in parental confidence in childhood vaccinations beyond COVID-19.

Vaccines are an essential component of public health because they protect the individual and their community. The authors show an increase of 13.2 percentage points in the proportion of parents who agreed that vaccines lead to illness or deaths and of 6.1 percentage points in the proportion of parents agreeing that childhood vaccines have many known harmful side effects. The sample did not allow for additional analysis to further discriminate which factors among parents were the main drivers of these changes, and additional studies to further identify these are urgently needed.

Vaccine hesitancy is a complex and often irrational problem that cannot be overcome just with knowledge. The health care system rewards quantity instead of quality, and we are often faced with limited time to have meaningful conversations with our patients and families. In addition, in this fast-paced world, the ability to pause, listen and take time to address this issue is increasingly challenging. Even more worrisome is the lack of preparation and resources we have to counteract the well-funded and prepared disinformation operation. We should expect this to worsen over time as we continue to lose ground against the antivaccine movement.

Although we, as pediatricians, can exercise patience, time, and empathy to tackle this problem, a coalition of disciplines, health policy, communicators and advocacy groups is fundamental to address the complexity of human behavior in health and disease.