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. 2025 May;64(4):570-582.
doi: 10.1177/00099228241281126. Epub 2024 Sep 28.

Parents' Willingness to Vaccinate Their Children Aged From 6 Months to Under 5 Years With COVID-19 Vaccines

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Parents' Willingness to Vaccinate Their Children Aged From 6 Months to Under 5 Years With COVID-19 Vaccines

An Hoai Duong. Clin Pediatr (Phila). 2025 May.

Abstract

Despite strides in vaccinating priority groups against COVID-19, children under 5 years in Vietnam are still under-immunized, emphasizing a significant gap in prioritization. This study aimed to assess parental willingness to vaccinate children aged 6 months to under 5 years against COVID-19 in Vietnam and identify influential factors affecting this willingness. Data were collected via a survey of 5960 parents/guardians between May and June 2022. Multinomial logistic regression was employed to analyze the impact of various factors on parents' willingness to vaccinate their children, alongside investigating reasons for reluctance or refusal and preferences for vaccine origins. Approximately 50.5%, 30.2%, and 19.3% of parents were willing, hesitant, and unwilling to vaccinate their children, respectively. Primary reasons for reluctance included concerns about vaccine safety, efficacy, and the severity of the pandemic. The most preferred vaccines originated in the United States. Factors significantly influencing willingness included parents' age, knowledge of COVID-19 and vaccines, residency, education, perception of information sufficiency, children's comorbidities, and family members' vaccination status. Promoting child vaccination habits can boost COVID-19 immunization rates. Targeting hesitancy among parents of children with comorbidities is crucial. Enhancing parental knowledge and leveraging fully vaccinated family members are effective strategies.

Keywords: COVID-19 pandemic; COVID-19 vaccines; SARS-CoV-2 virus; children aged from 6 months to under 5 years; parents’ willingness to vaccinate their children; stratified surveys.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Conceptual framework on the parents’ willingness to vaccinate their children aged from 6 months to under 5 years. Source: Adapted and illustrated by the author.
Figure 2.
Figure 2.
Characteristics of the parents and their families and their willingness to vaccinate their children aged from 6 months to under 5 years (measured in percentage). Source: Illustrated by the author using the surveyed data. X1 = respondent’s relationship with the children (1 = parents, 0 = guardians); X2 = respondent’s gender (1 = male, 0 = female); X3 = the number of children of the respondent (mean = 1 child); X4 = respondent’s age (mean = 36 years); X5 = residency of the respondent (1 = urban); X6 = marital status of the respondent (1 = married/cohabited, 0 = divorced/separated/widow/widower); X7 = respondent’s family poverty status (1 = non-poor); X8 = number of dependants (mean = 2, excluding the children) in the respondent’s family; X9 = respondent’s education (1 = tertiary or above); X10 = respondent had a permanent job with income (1 = yes); X11 = respondent was afraid that their unvaccinated children would be discriminated against (1 = yes); and X13 = respondent regularly vaccinated their children (1 = yes).
Figure 3.
Figure 3.
Parents’ information access and their willingness to vaccinate their children aged from 6 months to under 5 years old (measured in percentage). Source: Illustrated by the author using the surveyed data. X14 = respondent received information on the COVID-19 pandemic every day (1 = yes); X15 = respondent received information on the COVID-19 vaccines every day (1 = yes); X16 = respondent rated information on the COVID-19 pandemic as “sufficient” (1 = yes); and X17= respondent rated information on the COVID-19 vaccines as “sufficient” (1 = yes).
Figure 4.
Figure 4.
Children’s exposure to the SARS-CoV-2 virus and their parents’ willingness to vaccinate them (measured in percentage). Source: Illustrated by the author using the surveyed data. X12 = respondent’s children participated in kindergarten (1 = yes); X18 = respondent’s family had at least 1 person who belonged to the COVID-19 vaccine priority groups (1 = yes); X19 = respondent’s children had comorbidities (1 = yes); X28 = respondent was infected with the virus (1 = yes); X29 = at least 1 of the children’s close person was infected with the virus (1 = yes); X30 = all family members of the respondent were fully vaccinated (1 = yes); X31 = all of the children’s close persons were fully vaccinated (1 = yes); and X32 = respondent was afraid that their children would be infected with the virus (1 = yes).
Figure 5.
Figure 5.
Parents’ knowledge sufficiency (of the pandemic and virus) and their willingness to vaccinate their children aged from 6 months to under 5 years (measured in percentage). Source: Illustrated by the author using the surveyed data. X20 = respondent’s knowledge sufficiency about the popular symptoms of COVID-19 infection (1 = sufficient); X21 = respondent’s knowledge sufficiency about the SARS-CoV-2 virus transmission (1 = sufficient); X22 = respondent’s knowledge sufficiency about the correct ways to prevent the COVID-19 infection (1 = sufficient); X23 = respondent’s knowledge sufficiency about the speed of the SARS-CoV-2 virus spread (1 = sufficient); X24 = respondent’s knowledge sufficiency about the SARS-CoV-2 virus fatality (1 = sufficient); X25 = respondent’s knowledge sufficiency about the COVID-19 vaccine immunity longevity (1 = sufficient); X26 = respondent’s knowledge sufficiency about the herd immunity, which is reached when at least 70% of the population is fully vaccinated (1 = sufficient); and X27 = respondent’s knowledge sufficiency about the popular symptoms after being vaccinated (1 = sufficient).
Figure 6.
Figure 6.
Reasons that parents hesitated or refused to vaccinate their children aged from 6 months to under 5 years (measured in percentage). Source: Illustrated by the author using the surveyed data. Reason 1 = concerned about the side effects of the vaccines; Reason 2 = concerned about the possibility of myocarditis and pericarditis in children; Reason 3 = concerned about the long-term impacts of the vaccines on children’s fertility; Reason 4 = concerned about the vaccine efficacy; Reason 5 = the present vaccines were not developed for children; Reason 6 = the probability of children getting infected was low as people belonging to other age groups were almost fully vaccinated; Reason 7 = the number of COVID-19 cases in the community decreased; Reason 8 = the number of deaths (caused by COVID-19) in the community decreased; Reason 9 = the children have been infected and no need to be vaccinated.
Figure 7.
Figure 7.
Parents’ preferences for vaccine origin to vaccinate their children aged from 6 months to under 5 years (measured in percentage). Source: Calculated and illustrated by the author using the surveyed data. Vaccine 1 refers to the vaccines developed in the United States. Vaccine 2 refers to the vaccines developed in China.

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