COVID-19 pandemic not linked to changes in overall parental vaccine hesitancy
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Key takeaways:
- A study found no link between the COVID-19 pandemic and a change in overall vaccine hesitancy among parents.
- There were other noticeable effects, however, including a polarization of attitudes toward vaccination.
The COVID-19 pandemic was not associated with changes in parental vaccine hesitancy overall, but there were other effects, including a polarization of vaccine attitudes and changes in trust about vaccine information, a study found.
There were significant disruptions to childhood vaccine uptake during the COVID-19 pandemic, along with a rise in vaccine-related misinformation and disinformation, which raised concerns that vaccine hesitancy toward childhood vaccines had increased.
“Here in Colorado, we have been tracking vaccine confidence through our Health eMoms survey among birthing parents,” Sean T. O’Leary, MD, MPH, professor of pediatric infectious diseases at the University of Colorado School of Medicine and chair of the AAP’s Committee on Infectious Diseases, told Healio. “We worked with our state health department to look at the data and ask, ‘Is parents’ confidence in vaccines changing?’”
Validated scale
O’Leary and colleagues studied data from 3,553 respondents to the survey from April 2018 through August 2021. One section of the survey, which is completed between 3 and 6 months postpartum, measures parents’ attitudes about childhood vaccines.
“It's a validated scale of vaccine hesitancy, and what that means is people's responses on the survey predict future vaccination behavior,” O’Leary said.
According to the researchers, 20.4% of parents who responded could be defined as hesitant toward childhood vaccines. In general, however, parental vaccine hesitancy did not change from the pre-pandemic period to the post-pandemic period, and overall hesitancy for childhood vaccines did not increase.
The adjusted OR for parental vaccine hesitancy during the period of the COVID-19 pandemic before vaccines were available compared with the prepandemic period was 0.82 (95% CI, 0.65-1.04). The OR for vaccine hesitancy during the period of the COVID-19 pandemic after vaccines were available compared with the prepandemic period was 1.07 (95% CI, 0.85-1.34).
In the period of the COVID-19 pandemic after vaccines were available, parents were more than twice as likely to be unsure about trusting vaccine information than they were before the pandemic (OR = 2.14; 95% CI, 1.55-2.96).
Those who were hesitant about vaccines before the pandemic were around half as likely to be unsure about their hesitancy (OR = 0.48; 95% CI, 0.27-0.84), indicating a hardening of their views.
The authors noted that Black and Asian parents were more likely to be hesitant compared with white parents. The researchers suggested that polarization in attitudes toward childhood vaccines is likely the result of the growth of digital communications and political polarization.
“The biggest thing is to not just assume that the COVID-19 pandemic has had a major negative hit on parent attitudes about childhood vaccines,” O’Leary said.
He added that the issue with assuming that all parents are hesitant is that it can change “your message around the importance of vaccines.”
“It normalizes the behavior of being vaccine hesitant, and that may lead to more parents actually questioning or refusing vaccines [if you are] simply going into a patient encounter under the impression that parents are going to refuse the vaccine,” O’Leary said. “Most parents, based on both national data and the findings from this study are still vaccinating their children according to the recommended schedule. They still have mostly positive attitudes about childhood vaccines. I think pediatricians still should be going into these clinical visits with families with a very strong recommendation for pediatric vaccines, and assuming parents are on the same page with them.”
National surveillance system?
A second study published in Pediatrics and conducted among a focus group of 36 parents found that even parents who identified themselves as vaccine refusers or vaccine hesitant did mention that they would listen to their doctor for information about COVID-19 vaccines. Infertility was a common concern among all parents.
The studies were accompanied by a commentary from Melissa B. Gilkey, PhD and Noel T. Brewer, PhD, professors at the University of North Carolina's Gillings School of Global Public Health, who called for the development of a national surveillance system for vaccine confidence.
“National surveillance of vaccine confidence and hesitancy would be advantageous in providing clearer links to data on vaccine uptake,” they wrote. “Existing U.S. surveillance systems like the National Immunization Survey and Vaccine Safety Datalink offer vaccination data from medical records and can be coupled with parental reports of vaccine confidence and hesitancy. Such objective data sources on vaccine uptake offer clear advantages over the self-report data that are the mainstay of many regional studies and can help to clarify the complex relationship between vaccine-related beliefs, motivations, and behaviors.”
References:
Gilkey MB, et al. Pediatrics. 2023;doi:10.1542/peds.2023-063169.
Higgins DM, et al. Pediatrics. 2023;doi:1542/peds.2023-062927.
Honcoop A, et al. Pediatrics. 2023;doi:10.1542/peds.2023-062466.
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