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Original article

Vol. 152 No. 1112 (2022)

Confident and altruistic – parents’ motives to vaccinate their children against COVID-19: a cross-sectional online survey in a Swiss vaccination centre

  • Aylin Wagner
  • Florian Liberatore
  • Sarah Schmelzer
  • Julia Dratva
DOI
https://doi.org/10.4414/SMW.2022.w30156
Cite this as:
Swiss Med Wkly. 2022;152:w30156
Published
18.03.2022

Summary

AIMS OF THE STUDY: In Switzerland, COVID-19 vaccines have been approved for children aged 5–11 years only recently, whereas vaccination of adolescents aged 12 years and older was approved in early summer 2021. Although the disease burden in children and adolescents has been reasonably mild, they can transmit COVID-19 to others, thus vaccinating this age group may help to curb the COVID-19 pandemic. The main objective was to investigate the association between five psychological antecedents of vaccination hesitancy in COVID-19 immunised parents and their intention to have their child vaccinated against COVID-19. Further, we examined if parental vaccination history and conviction of the benefits of Swiss paediatric vaccination recommendations are associated with child vaccination intention, and where parents would like the vaccination performed. 

METHODS: A cross-sectional anonymous online survey in the COVID-19 vaccination centre Winterthur was conducted between 16 May and 30 September 2021. Individuals receiving COVID-19 vaccines in the vaccination centre were invited to participate. All individuals who participated in the survey after their first dose with children under 16 years were included in the analysis (n = 1318). Using multivariable logistic regression, the association between our main predictor variables, psychological antecedents (confidence, constraints, complacency, calculation, collective responsibility) measured by the validated 5C scale, and parents’ intention to have their child vaccinated against COVID-19 was analysed, adjusted for parental vaccination history, conviction of benefits of vaccination recommendations for children and adults, children’s age group, sociodemographic factors, and time-point of vaccine authorisation for 12–16-year-olds.

RESULTS: 58.7% of the parents intended to vaccinate their child against COVID-19. Their preferred vaccination location for their child was the paediatrician or family doctor. Three psychological antecedents were associated with vaccination intention: confidence (adjusted odds ratio [AOR] 1.33, 95% confidence interval [CI] 1.00–1.76; borderline significant), calculation (AOR 0.68, 95% CI 0.58–0.81), and collective responsibility (AOR 1.93, 95% CI 1.47–2.52). Influenza vaccination (AOR 1.53, 95% CI 1.15–2.03) and conviction of the benefits of the Swiss vaccination recommendations for children and adolescents were independently associated with parental vaccination intention.

CONCLUSIONS: Campaigns on COVID-19 vaccination for children may increase the intention of parents to have a child vaccinated when they address collective responsibility and calculation (weighing risks and benefits), independent of the conviction of the benefits of the vaccination recommendations, which was also a significant factor. The findings further show that parents of younger children favour their paediatrician or family doctor over vaccination centres as the vaccination setting for their child, an important finding for paediatric COVID-19 vaccination strategies.

References

  1. Wang Q, Xiu S, Zhao S, Wang J, Han Y, Dong S, et al. Vaccine Hesitancy: COVID-19 and Influenza Vaccine Willingness among Parents in Wuxi, China-A Cross-Sectional Study. Vaccines (Basel). 2021 Apr;9(4):342. https://doi.org/10.3390/vaccines9040342
  2. Goldman RD, Yan TD, Seiler M, Parra Cotanda C, Brown JC, Klein EJ, et al.; International COVID-19 Parental Attitude Study (COVIPAS) Group. Caregiver willingness to vaccinate their children against COVID-19: cross sectional survey. Vaccine. 2020 Nov;38(48):7668–73. https://doi.org/10.1016/j.vaccine.2020.09.084
  3. Wiedenmann M, Goutaki M, Keiser O, Stringhini S, Tanner M, Low N. The role of children and adolescents in the SARS-CoV-2 pandemic: a rapid review. Swiss Medical Weekly. 2021 Sep 17;(37).
  4. Obaro S. COVID-19 herd immunity by immunisation: are children in the herd? Lancet Infect Dis. 2021 Jun;21(6):758–9. https://doi.org/10.1016/S1473-3099(21)00212-7
  5. Feldstein LR, Rose EB, Horwitz SM, Collins JP, Newhams MM, Son MB, et al.; Overcoming COVID-19 Investigators; CDC COVID-19 Response Team. Multisystem Inflammatory Syndrome in U.S. Children and Adolescents. N Engl J Med. 2020 Jul;383(4):334–46. https://doi.org/10.1056/NEJMoa2021680
  6. Buonsenso D, Munblit D, De Rose C, Sinatti D, Ricchiuto A, Carfi A, et al. Preliminary evidence on long COVID in children. Acta Paediatr. 2021 Jul;110(7):2208–11. https://doi.org/10.1111/apa.15870
  7. Asadi-Pooya AA, Nemati H, Shahisavandi M, Akbari A, Emami A, Lotfi M, et al. Long COVID in children and adolescents. World J Pediatr. 2021 Oct;17(5):495–9. https://doi.org/10.1007/s12519-021-00457-6
  8. Brackel CL, Lap CR, Buddingh EP, van Houten MA, van der Sande LJ, Langereis EJ, et al. Pediatric long-COVID: an overlooked phenomenon? Pediatr Pulmonol. 2021 Aug;56(8):2495–502. https://doi.org/10.1002/ppul.25521
  9. Schleiss MR, John CC, Permar SR. Children are the key to the Endgame: A case for routine pediatric COVID vaccination. Vaccine. 2021 Sep;39(38):5333–6. https://doi.org/10.1016/j.vaccine.2021.08.005
  10. Federal Office of Public Health FOPH. Coronavirus: Vaccination [Internet]. bag.admin.ch. 2021 [cited 2021 Jul 5]. Available from: https://www.bag.admin.ch/bag/en/home/krankheiten/ausbrueche-epidemien-pandemien/aktuelle-ausbrueche-epidemien/novel-cov/impfen.html
  11. Swissmedic. Covid-19 Impfstoff von Pfizer/BioNTech in der Schweiz für Jugendliche freigegeben [Internet]. www.swissmedic.ch. 2021 [cited 2021 Oct 29]. Available from: https://www.swissmedic.ch/swissmedic/de/home/news/coronavirus-covid-19/covid-19-impfstoff-pfizer-biontech-fuer-jugendliche.html
  12. Swissmedic. Swissmedic genehmigt Covid-19 Impfstoff von Pfizer/BioNTech für Kinder von 5 bis 11 Jahren [Internet]. www.swissmedic.ch. 2021 [cited 2021 Dec 15]. Available from: https://www.swissmedic.ch/swissmedic/de/home/news/coronavirus-covid-19/covid-19-impfstoff-pfizer-biontec-kinder-5-11-jahren-genehmigt.html
  13. Nilsson S, Mattson J, Berghammer M, Brorsson AL, Forsner M, Jenholt Nolbris M, et al. To be or not to be vaccinated against COVID-19 - The adolescents’ perspective - A mixed-methods study in Sweden. Vaccine X. 2021 Dec;9:100117. https://doi.org/10.1016/j.jvacx.2021.100117
  14. Hermann M. Spezialauswertung COVID-19-Impfung: Informationsstand, Einstellungen und Verhalten. Auszug aus der periodischen Wirkungsmessung März 2021 im Auftrag des Bundesamts für Gesundheit BAG. Bern: Forschungsstelle sotomo; 2021.
  15. Betsch C, Schmid P, Heinemeier D, Korn L, Holtmann C, Böhm R. Beyond confidence: development of a measure assessing the 5C psychological antecedents of vaccination. PLoS One. 2018 Dec;13(12):e0208601. https://doi.org/10.1371/journal.pone.0208601
  16. Shapiro GK, Kaufman J, Brewer NT, Wiley K, Menning L, Leask J, et al.; BeSD Working Group. A critical review of measures of childhood vaccine confidence. Curr Opin Immunol. 2021 Aug;71:34–45. https://doi.org/10.1016/j.coi.2021.04.002
  17. Waller J, Forster A, Ryan M, Richards R, Bedford H, Marlow L. Decision-making about HPV vaccination in parents of boys and girls: A population-based survey in England and Wales. Vaccine. 2020 Jan;38(5):1040–7. https://doi.org/10.1016/j.vaccine.2019.11.046
  18. Humble RM, Sell H, Dubé E, MacDonald NE, Robinson J, Driedger SM, et al. Canadian parents’ perceptions of COVID-19 vaccination and intention to vaccinate their children: results from a cross-sectional national survey. Vaccine. 2021 Dec;39(52):7669–76. https://doi.org/10.1016/j.vaccine.2021.10.002
  19. Skjefte M, Ngirbabul M, Akeju O, Escudero D, Hernandez-Diaz S, Wyszynski DF, et al. COVID-19 vaccine acceptance among pregnant women and mothers of young children: results of a survey in 16 countries. Eur J Epidemiol. 2021 Feb;36(2):197–211. https://doi.org/10.1007/s10654-021-00728-6
  20. Choi SH, Jo YH, Jo KJ, Park SE. Pediatric and Parents’ Attitudes Towards COVID-19 Vaccines and Intention to Vaccinate for Children. J Korean Med Sci. 2021 Aug;36(31):e227. https://doi.org/10.3346/jkms.2021.36.e227
  21. Zhang MX, Lin XQ, Chen Y, Tung TH, Zhu JS. Determinants of parental hesitancy to vaccinate their children against COVID-19 in China. Expert Rev Vaccines. 2021 Oct;20(10):1339–49. https://doi.org/10.1080/14760584.2021.1967147
  22. Szilagyi PG, Shah MD, Delgado JR, Thomas K, Vizueta N, Cui Y, et al. Parents’ Intentions and Perceptions About COVID-19 Vaccination for Their Children: Results From a National Survey. Pediatrics. 2021 Oct;148(4):e2021052335. https://doi.org/10.1542/peds.2021-052335
  23. Hetherington E, Edwards SA, MacDonald SE, Racine N, Madigan S, McDonald S, et al. SARS-CoV-2 vaccination intentions among mothers of children aged 9 to 12 years: a survey of the All Our Families cohort. CMAJ Open. 2021 May;9(2):E548–55. https://doi.org/10.9778/cmajo.20200302
  24. Altenbuchner A, Haug S, Schnell R, Scharf A, Weber K. Impfbereitschaft von Eltern mit einem COVID-19-Vakzin: Die Rolle von Elternschaft und Geschlecht. Padiatr Padol. 2021 Oct;56(5):230–4. https://doi.org/10.1007/s00608-021-00925-2
  25. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP ; STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008 Apr;61(4):344–9. https://doi.org/10.1016/j.jclinepi.2007.11.008
  26. Studie zur Gesundheit von Studierenden in Zeiten der Corona-Pandemie. [Internet]. ZHAW Gesundheit. [cited 2021 Aug 19]. Available from: https://www.zhaw.ch/de/gesundheit/forschung/gesundheitswissenschaften/projekte/studierendengesundheit/
  27. Federal Office of Public Health FOPH. COVID-⁠19 Switzerland | Coronavirus | Dashboard [Internet]. www.covid19.admin.ch. [cited 2022 Feb 14]. Available from: https://www.covid19.admin.ch/en/vaccination/persons?geoAge=A_5_11
  28. Dratva J, Wagner A, Zysset A, Volken T. To Vaccinate or Not to Vaccinate-This Is the Question among Swiss University Students. Int J Environ Res Public Health. 2021 Aug;18(17):9210. https://doi.org/10.3390/ijerph18179210
  29. Al-Sanafi M, Sallam M. Psychological Determinants of COVID-19 Vaccine Acceptance among Healthcare Workers in Kuwait: A Cross-Sectional Study Using the 5C and Vaccine Conspiracy Beliefs Scales. Vaccines (Basel). 2021 Jun;9(7):701. https://doi.org/10.3390/vaccines9070701
  30. Kwok KO, Li KK, Wei WI, Tang A, Wong SY, Lee SS. Editor’s Choice: Influenza vaccine uptake, COVID-19 vaccination intention and vaccine hesitancy among nurses: A survey. Int J Nurs Stud. 2021 Feb;114:103854. https://doi.org/10.1016/j.ijnurstu.2020.103854
  31. Kwok KO, Li KK, Tang A, Tsoi MT, Chan EY, Tang JW, et al. Psychobehavioral Responses and Likelihood of Receiving COVID-19 Vaccines during the Pandemic, Hong Kong. Emerg Infect Dis. 2021 Jul;27(7):1802–10. https://doi.org/10.3201/eid2707.210054
  32. Sherman SM, Smith LE, Sim J, Amlôt R, Cutts M, Dasch H, et al. COVID-19 vaccination intention in the UK: results from the COVID-19 vaccination acceptability study (CoVAccS), a nationally representative cross-sectional survey. Hum Vaccin Immunother. 2021 Jun;17(6):1612–21. https://doi.org/10.1080/21645515.2020.1846397
  33. Mo PK, Luo S, Wang S, Zhao J, Zhang G, Li L, et al. Intention to Receive the COVID-19 Vaccination in China: Application of the Diffusion of Innovations Theory and the Moderating Role of Openness to Experience. Vaccines (Basel). 2021 Feb;9(2):129. https://doi.org/10.3390/vaccines9020129
  34. Rosen B, Waitzberg R, Israeli A, Hartal M, Davidovitch N. Addressing vaccine hesitancy and access barriers to achieve persistent progress in Israel’s COVID-19 vaccination program. Isr J Health Policy Res. 2021 Aug;10(1):43. https://doi.org/10.1186/s13584-021-00481-x
  35. Teasdale CA, Borrell LN, Kimball S, Rinke ML, Rane M, Fleary SA, et al. Plans to Vaccinate Children for Coronavirus Disease 2019: A Survey of United States Parents. J Pediatr. 2021 Oct;237:292–7. https://doi.org/10.1016/j.jpeds.2021.07.021
  36. Bono SA, Faria de Moura Villela E, Siau CS, Chen WS, Pengpid S, Hasan MT, et al. Factors Affecting COVID-19 Vaccine Acceptance: An International Survey among Low- and Middle-Income Countries. Vaccines (Basel). 2021 May;9(5):515. https://doi.org/10.3390/vaccines9050515
  37. Murphy J, Vallières F, Bentall RP, Shevlin M, McBride O, Hartman TK, et al. Psychological characteristics associated with COVID-19 vaccine hesitancy and resistance in Ireland and the United Kingdom. Nat Commun. 2021 Jan;12(1):29. https://doi.org/10.1038/s41467-020-20226-9
  38. Thaker J. The Persistence of Vaccine Hesitancy: COVID-19 Vaccination Intention in New Zealand. J Health Commun. 2021 Feb;26(2):104–11. https://doi.org/10.1080/10810730.2021.1899346
  39. Schwarzinger M, Watson V, Arwidson P, Alla F, Luchini S. COVID-19 vaccine hesitancy in a representative working-age population in France: a survey experiment based on vaccine characteristics. Lancet Public Health. 2021 Apr;6(4):e210–21. https://doi.org/10.1016/S2468-2667(21)00012-8
  40. Ruiz JB, Bell RA. Predictors of intention to vaccinate against COVID-19: results of a nationwide survey. Vaccine. 2021 Feb;39(7):1080–6. https://doi.org/10.1016/j.vaccine.2021.01.010
  41. Robinson E, Jones A, Lesser I, Daly M. International estimates of intended uptake and refusal of COVID-19 vaccines: A rapid systematic review and meta-analysis of large nationally representative samples. Vaccine. 2021 Apr;39(15):2024–34. https://doi.org/10.1016/j.vaccine.2021.02.005
  42. Kempe A, Saville AW, Albertin C, Zimet G, Breck A, Helmkamp L, et al. Parental Hesitancy About Routine Childhood and Influenza Vaccinations: A National Survey. Pediatrics. 2020 Jul;146(1):e20193852. https://doi.org/10.1542/peds.2019-3852
  43. Rammohan A, Awofeso N, Fernandez RC. Paternal education status significantly influences infants’ measles vaccination uptake, independent of maternal education status. BMC Public Health. 2012 May;12(1):336. https://doi.org/10.1186/1471-2458-12-336
  44. Hudson A, Montelpare WJ. Predictors of Vaccine Hesitancy: Implications for COVID-19 Public Health Messaging. Int J Environ Res Public Health. 2021 Jul;18(15):8054. https://doi.org/10.3390/ijerph18158054
  45. Temsah MH, Alhuzaimi AN, Aljamaan F, Bahkali F, Al-Eyadhy A, Alrabiaah A, et al. Parental Attitudes and Hesitancy About COVID-19 vs. Routine Childhood Vaccinations: A National Survey. Front Public Health. 2021 Oct;9:752323. https://doi.org/10.3389/fpubh.2021.752323
  46. Begleitstudie COVID-Impfzentrum Winterthur [Internet]. ZHAW Gesundheit. [cited 2021 Nov 5]. Available from: https://www.zhaw.ch/de/gesundheit/forschung/gesundheitswissenschaften/projekte/begleitstudie-covid-impfzentrum-winterthur/
  47. Bundesamt für Gesundheit BAG. Coronavirus: Massnahmen und Verordnungen [Internet]. bag.admin.ch. [cited 2021 Nov 5]. Available from: https://www.bag.admin.ch/bag/de/home/krankheiten/ausbrueche-epidemien-pandemien/aktuelle-ausbrueche-epidemien/novel-cov/massnahmen-des-bundes.html

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