CS000000-A | 12/16/22

Centers for Disease Control & Prevention, 

COVID-19 Response, Vaccine Task Force

Vaccine Confidence & Demand Team, Insights Unit

The findings and conclusions in this report are those 

of the author(s) and do not necessarily represent 

the official position of the Centers for Disease 

Control and Prevention (CDC).

CDC’s State of Vaccine 

Confidence 

Insights Report

2nd COVID-19 Vaccine Summary 

Report: 6 months through 5 years

December 16, 2022

Date Range: August 1, 2021 – August 10, 2022
Page: 2

State of Vaccine Confidence Insights Report | December 16, 2022

Summary of the 2nd COVID-19 Vaccine Summary Report: 6 months 

through 5 years

This report consolidates findings and 

ways public health partners can act on 

the findings related to COVID-19 vaccines 

for children 6 months through 5 years of 

age from CDC’s COVID-19 State of Vaccine 

Confidence Report (SoVC) #26, SoVC #27, 

and SoVC #28, reflecting data collected 

from March 14, 2022, through May 31, 2022. 

In February 2022, the Insights Unit published the COVID-19 SoVC 

Vaccines for Children Summary Report. The data collection period 

for that report was from November 9, 2021, to January 10, 2022. 

That report can be found here. All past reports are online here. CDC 

also publishes a quarterly report on themes impacting vaccine 

confidence in the United States. 

This report is meant to give CDC partners a better understanding 

of the perceptions, concerns, frustrations, and circulating 

misinformation about the COVID-19 vaccines for children 6 months 

through 5 years of age that were expressed. Examples and data 

pertaining to other age ranges are included to show patterns or to 

provide additional context.

During these data collection periods, the Insights Unit has seen an 

average of 9,138 online mentions of COVID-19 vaccines for children 

per day, with a spike on April 28, 2022, to 37,737 when Moderna 

submitted their COVID-19 vaccine pediatric trial data to the Food 

and Drug Administration (FDA). In addition, parental concerns 

related to the effectiveness and safety of COVID-19 vaccines for 

children through 5 years of age appeared through all of our data 

sources, including social media, news stories, third-party reports, 

and Google search trends. The Insights Unit has classified “concerns 

about the effectiveness and safety of COVID-19 vaccines for children” 

as having a high risk of impacting vaccine confidence. 

Resources: The following link contains social media resources 

such as graphics, language, and social media calendars that 

our partners can use these resources to help educate their 

constituents and build vaccine confidence by addressing the 

themes in this report: 

https://centersfordiseasecontrol.sharefile.com/dse1bf5c187f6a4eb5a72e1490de2506a8

Contents

2

Overview

4

Perceptions, Concerns, and Threat to 

Vaccine Confidence

6

Information voids and commonly 

asked questions from the public

7

Identified misinformation themes 

that may impact vaccine confidence

8

Ways public health and partners 

can take action to improve vaccine 

confidence

10

Appendix: Inputs and Sources
Page: 3

State of Vaccine Confidence Insights Report | December 16, 2022

Consumers continued to have concerns about the 

effectiveness and safety of COVID-19 pediatric vaccinesa

Backgroundb

This report was created to give CDC partners a better understanding of the perceptions, 

concerns, frustrations, and circulating misinformation that emerged or intensified after CDC’s 

endorsement of the Advisory Committee on Immunization Practices (ACIP) recommendation 

for use of the Pfizer-BioNTech COVID-19 vaccine and the Moderna COVID-19 vaccine for 

children ages 6 months–4 years and 6 months–5 years.

Since the U.S. Food and Drug Administration (FDA) authorized the Pfizer-BioNTech 

COVID-19 vaccine for emergency use in children ages 5 through 11 years on October 

29, 2021,1

 parents on social media and other social media users have been expressing 

their concern about adverse events and unknown long-term side effects of the vaccine, 

citing incomplete and rushed trials as the cause of their apprehension.2,3,4 Reports that some 

vaccine clinics accidentally administered the adult dosage, rather than the pediatric dosage, 

to children ages 5–11 years5,6

 continued to circulate since then and may also have negatively 

impacted public confidence.

On April 28, 2022, Moderna formally submitted its clinical trial data to the FDA for 

authorization of its COVID-19 vaccine in children 6 months through 5 years of age.7

 Likely 

in response to this announcement, searches for “moderna vaccine for kids under 5” rose by 

250% compared to the previous two weeks.c

 After the submission of the clinical trial data, 

many parents also called on the FDA to rapidly approve vaccines for children younger than 

6 years of age.8,9

 Additionally, Pfizer submitted data to the FDA for authorization of a booster 

dose for children 5–11 years of age.10 Some parents were relieved and hopeful at the notion 

of potentially being one step closer to getting their child vaccinated against COVID-19.11,12

However, others were still frustrated with the process, and that emergency use authorization 

had not been granted for children through 5 years.13,14,15 Some individuals advocated for 

CDC to recommend off-label use of the COVID-19 vaccine to get kids through 5 years of 

age vaccinated, while others advocated for off-label without CDC’s recommendation.16,17

Consumers continued to raise concerns over side effects,18,19 to believe vaccination is 

unnecessary in this age group,20,21 and to cite a lack of data to support COVID-19 vaccination of 

children.22,23

On June 1, 2022, news outlets reported that Pfizer also submitted data to the FDA for 

emergency use authorization of its 3-dose COVID-19 vaccine in children ages 6 months 

through 4 years.24 The Vaccines and Related Biological Products Advisory Committee (VRBPAC) 

a

Citations in this report are illustrative examples and are not the total number of instances of the corresponding themes.

b

Social media citations can be found in this linked document.

c

Google Trends
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State of Vaccine Confidence Insights Report | December 16, 2022

meeting to discuss the emergency use authorization of COVID-19 vaccines in this age group 

took place on June 14-15, 2022.25 On June 18, 2022, CDC endorsed the Advisory Committee 

on Immunization Practices (ACIP) recommendation for use of the Pfizer-BioNTech COVID-19 

vaccine and the Moderna COVID-19 vaccine for children aged 6 months–4 years.29

Perceptions, Concerns, and Threat to Vaccine 

Confidence

 While some parents are against it, others remain advocates for COVID-19 vaccinations in 

children less than 6 years of age.30,31

 Some social media users believe that COVID-19 vaccines are ineffective at stopping 

COVID-19 or the spread of the virus in children.32,33

 Some consumers believe that the COVID-19 vaccine is not 

warranted in children because they are considered a low-risk 

population with minimal health effects from the virus and 

have a low death rate.34,35,36,37,38

 Parents are hesitant to vaccinate their children because they 

fear serious side effects, adverse events, and unknown longterm side effects.39,40,41,42,43

 Some government officials made public statements against 

COVID-19 vaccines for healthy children.44

 Consumers believe the FDA is not moving as fast as it should to authorize use of COVID-19 

vaccines in children.45,46

 Some health experts believe that 

low vaccine confidence has led to 

low COVID-19 vaccination levels in 

children.47,48

 Some believe infection-induced 

immunity provides more protection to children than vaccines do.49,50,51,52,53

 Some social media users do not think there is enough data to support vaccination against 

COVID-19 in children.54,55,56

 WHO issued a global alert after recent reports of severe hepatitis in children rising globally. 

Some believe they are caused by COVID-19 vaccines.57,58,59

 Some are concerned that since vaccine-induced immunity decreased rapidly in adolescents 

after the COVID-19 vaccine primary series, the same decrease occur among children through 

5 years of age.60,61

 A Meltwater sentiment analysis of social media, websites, and news stories’ mentions of 

vaccine and child, children, or kid (n = 1.06 million) between March 19, 2022 and June 16, 

2022 found that 8% were positive mentions, 29% were negative, and 61% were neutral.

 A Kaiser Family Foundation poll found that 17% of parents with children younger than 5 

years old will get their child vaccinated right away, while 38% say they plan to wait and 

see how the vaccine is working for others, 27% say they will definitely not get their child 

vaccinated, and 11% say they will only do so if they are required.62,63  
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State of Vaccine Confidence Insights Report | December 16, 2022

 The HHS Current Events Tracker shared the following polling results:d

 More than two-fifths of parents with unvaccinated children ages 0–4 said they were 

concerned about their child getting a COVID-19 infection. 

 A majority of parents with unvaccinated children ages 2–15 said they were concerned 

about their children having side effects from the COVID-19 vaccine. 

 Roughly 40% of parents with children ages 6 months through 4 years old said they were 

likely to get their child vaccinated if a COVID-19 vaccine was authorized. 

 Parents with unvaccinated children ages 5–11 remain unlikely to get their children 

vaccinated.

 46% of adults have heard or read about developments in vaccines for children through the 

age of 5.

d

Pope, M., DelGreco, M., Greenberg, D., Mannan, S., & Brunson, T. (2022). Current Events Tracker Wave 

60. Department of Health and Human Services (HHS), Office of the Assistant Secretary for Public Affairs 

(ASPA).
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State of Vaccine Confidence Insights Report | December 16, 2022

Information voids and commonly asked questions from 

the publice

 Should children be vaccinated before international travel?f

 CDC recommends that everyone eligible for COVID-19 vaccination be up to date with COVID-19 

vaccines before travel, which includes a complete primary series and the most recent booster 

dose recommended for a person by CDC.

64

 Why should a child through the age of six be vaccinated if they are less likely to experience 

negative health outcomes from COVID-19?

 Like adults, children and teens can get very sick from COVID-19, have both short- and longterm health problems, and spread COVID-19 to others, including at home and school. There 

is no way to tell in advance how children or teens will be affected by COVID-19. Those with 

underlying medical conditions or a weakened immune system are more likely to get severely 

ill from COVID-19, so the need for vaccination is greater for these people.65

 Do COVID-19 vaccines cause myocarditis?

 There is no evidence of an increased risk for myocarditis following mRNA COVID-19 

vaccination in children ages 6 months–5 years66

 Although rare, cases of myocarditis reported to the Vaccine Adverse Event Reporting System 

(VAERS) have occurred after mRNA COVID-19 vaccination (Pfizer-BioNTech or Moderna), 

especially in males 12 to 39 years old, more often after the second dose and usually within 

a week of vaccination. Most patients with myocarditis or pericarditis who received care 

responded well to medicine and rest and felt better quickly.67

 Cases of myocarditis and pericarditis were identified in clinical trials of Novavax COVID-19 

Vaccine and have also been reported during post-authorization use outside the United 

States. These findings suggest that an increased risk for these conditions may be present 

after receiving Novavax COVID-19 vaccine.68

 What are the COVID-19 vaccines authorized for use in children? 

 As of June 18, 2022, everyone 6 months through 5 years is recommended to get a Moderna 

or Pfizer-BioNTech COVID-19 vaccine for primary vaccination.69

 What are common COVID-19 vaccine side effects in children? 

 Common side effects for children 6 months through 3 years include: 70

 Pain on the leg or arm where the shot was given

 Swollen lymph nodes

 Irritability or crying

 Sleepiness

 Loss of appetite

 Common side effects for children ages 3 through 17 years were more common after the 

second dose and include:

 Pain, swelling, and redness on the arm where the shot was given

e

These questions come from online data sources such as social media, news stories, Google Trends, and 

CDC-INFO

f

CDC-INFO
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State of Vaccine Confidence Insights Report | December 16, 2022

 Tiredness

 Headache

 Muscle or joint pain

 Chills

 Swollen lymph nodes

 Should children through the age of 5 still wear masks? 

 Wearing a well-fitting mask consistently and correctly reduces the risk of spreading 

the virus that causes COVID-19. Universal indoor mask use is recommended at a high 

COVID-19 Community Level. Mask use is not recommended for those younger than 2 years 

old and may be difficult for very young children or for some children with disabilities who 

cannot safely wear a mask.

71

 Can the COVID-19 vaccines cause the cases of hepatitis of unknown cause recently seen in 

children? 

 There is no evidence that COVID-19 vaccines cause hepatitis. CDC continues to research 

possible causes for new cases of hepatitis among children, including testing for and 

ruling out some of the viruses that commonly cause hepatitis (hepatitis A, B, C, D, and 

E). Adenovirus has been detected in nearly half of the children and continues to be a 

strong lead. Further laboratory tests are being conducted to look more closely at the 

virus genome and other potential pathogens, such as SARS-CoV-2. In addition, CDC is 

communicating with key medical groups and continues to provide updated reporting 

and laboratory guidance for clinicians who may identify hepatitis of unknown cause in 

children.72

 When will vaccines be available for children through 5 years of age? 

 As of June 18, 2022, everyone 6 months through 5 years is recommended to get a 

Moderna or Pfizer-BioNTech COVID-19 vaccine for primary vaccination.73

Identified misinformation themes that may impact 

vaccine confidence

 Healthy children do not need to receive the COVID-19 vaccine.74

 COVID-19 vaccines are ineffective for children.75

 The COVID-19 vaccine is an experiment on children and is not needed because children can 

build “natural immunity” through virus exposure.76

 Children vaccinated against COVID-19 are up to 52 times more likely to die following 

COVID-19 vaccination than unvaccinated children.77,78,79

 Children have a high risk of death from receiving the COVID-19 vaccines.80,81

 COVID-19 poses no risk to children.82,83

 Children are getting hepatitis from the COVID-19 vaccines.84

 The virus that causes COVID-19 does not infect children.85,86,87

 Authorizing vaccines in children is only a ploy for pharmaceutical companies to make 

money.88,89,90
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State of Vaccine Confidence Insights Report | December 16, 2022

Ways public health and partners can take action to 

improve vaccine confidence 

Work with community partners and trusted messengers, including pediatricians, teachers, 

coaches, parents, and trusted local community messengers, to create and disseminate 

messages related to the following topics:

1. Messages that clearly explain the differences in rates of symptomatic infection for 

unvaccinated and vaccinated children through 5 years of age that contracted SARSCoV-2.91

2. Messages the clearly convey that evidence supports extended vaccine administration 

intervals might decrease the risk of myocarditis after vaccination.92,93,94

3. Messages that note the higher risk of myocarditis from SARS-CoV-2 infection when 

compared to the risk of myocarditis from COVID-19 vaccination such as “COVID-19 is 

more likely than vaccines to cause myocarditis, and symptoms and outcomes are often 

worse.”95

4. Messages for parents of children less than 5 years of age that note cases of myocarditis 

occurred most frequently in adolescent and young adult males, ages 16 years and older, 

within 7 days after receiving the second dose of an mRNA COVID-19 vaccine (PfizerBioNTech and Moderna).96

5. Materials detailing the benefits of vaccination over infection-induced immunity, 

especially emphasizing the risk of negative health outcomes of COVID-19 in children 

through 5 years of age.

6. Messages that reassure parents that the safety monitoring for COVID-19 vaccination in 

children through 5 is ongoing post authorization. 

7. Messages that accurately describe the side effects and risk of side effects of COVID-19 

vaccination in children. 

8. Information regarding safety precautions that would help reduce exposure risk for 

children who are not yet eligible for the vaccine, whose parents decline to vaccinate 

their children, and for parents of children who are not able to vaccinate due to possible 

medical contraindications. 

9. Messages and talking points for pediatric healthcare providers to assist them in their 

conversations with parents and caregivers that include motivational interviewing 

and empathic communication techniques, and evidence-based ways to counter 

misinformation.

10. Plain language messages using findings from these two MMWR reports to educate 

people on the safety of the vaccine for children and the risk of severe COVID-19 illness in 

children: 

 COVID-19 mRNA Vaccine Safety Among Children Aged 6 Months–5 Years — United 

States, June 18, 2022–August 21, 2022

 Trends in COVID-19 Cases, Emergency Department Visits, and Hospital Admissions 

Among Children and Adolescents Aged 0–17 Years — United States, August 2020–

August 2021

11. Continue to provide up-to-date data regarding adverse events, side effects, and benefits 

of COVID-19 vaccination among children through 5 years of age. 
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State of Vaccine Confidence Insights Report | December 16, 2022

12. Recent evidence suggests that individuals who hear information about a new technology 

in an audio format are more likely to perceive less risk and higher benefit to using the 

new technology than when presented in a written format. Therefore, consider creating 

and disseminating audio messages related to the safety and efficacy of COVID-19 

vaccines for children through 5 years of age through radio and social media platforms.

13. Use evidence-based strategies when mitigating misinformation about COVID-19 

vaccines, such as:

 Prioritize countering misinformation that has a significant risk to vaccine confidence 

when disseminating messages. 

 Consider presenting the misinformation as a question instead of a myth, as some 

evidence suggests presenting misinformation as a myth may decrease comprehension.

 Respond to misinformation by sharing messages that address the underlining concern 

without mentioning the misinformation narrative. For example, if the misinformation 

concerns a supposed vaccine side effect, share messaging detailing COVID-19 vaccine 

safety data and/or messaging that conveys an emotive story that reinforces the belief 

that vaccines are safe.

 If the misinformation persists and it has a high potential for impact, craft messages that 

use these evidence-based messaging strategies:

 “For XYZ to occur, these are the plausible biological mechanisms that would be 

required, and this is why that is not likely.”

 “It is not possible for the vaccines to cause XYZ because of this reason.”

 “We looked into XYZ by reviewing DATA SOURCE A and DATA SOURCE B, and we 

didn’t find it.”

 “We know what could cause XYZ and it is CAUSE, not the vaccine.”

 “There is no evidence that XYZ is true.”
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State of Vaccine Confidence Insights Report | December 16, 2022

Appendix: Inputs and Sources

Social Media Listening & Media Monitoring Data Sources

Input Cadence Sources Tactics for Utilization

Communication 

Surveillance Report

Daily on 

weekdays

Google news

Meltwater

CrowdTangle

Native platform searches

Share of voice topic analysis to 

identify themes

Emerging topics 

Meltwater Daily Facebook, Twitter, 

Instagram

Blogs

News media

Online forums

Share of voice topic analysis

Emerging theme topics

Identify high reach/velocity 

topics

OADC (Office of the 

Associate Director 

of Communication) 

Channel COVID-19 

Post metrics

Weekly Sprout Social

Native OADC (Office of 

the Associate Director 

of Communication) 

account analytics

Analyze # of posts, topics 

Success of messages, # 

of impressions, reach, # 

engagements

OADC Channel 

Comment Analysis

Daily on 

weekdays

Native platform searches Sentiment analysis

Identify message gaps/voids

Direct Report Data Sources

Input Cadence Sources Tactics for Utilization

CDC-INFO Metrics Weekly CDC-INFO inquiry line list

Prepared response (PR) 

usage report

Cross-compare PR usage with 

inquiry theme analysis

Sentiment analysis

Identify information gaps/

voids

VTF Media Requests Weekly Media request line list Leading indicator for news 

coverage

Identify information gaps/

voids

Web Metrics Weekly Top pages

Google search queries

Top FAQs

Referring domains

Identify information gaps/

voids,

Identify keywords/search 

terms, changes in web traffic
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State of Vaccine Confidence Insights Report | December 16, 2022

Research and Literature Data Sources

Input Cadence Sources Tactics for Utilization

Poll Review Weekly Harris Poll, PEW 

research, Gallup Poll, 

KFF, Annenberg Public 

Policy Center 

New data related to 

vaccine hesitancy

Identify socio-behavior indicators 

related to motivation and 

intention to vaccinate 

Literature Review Weekly PubMed, LitCovid, 

ProQuest Central, 

Altmetric 

New data related to 

vaccine hesitancy

Identify current vaccination 

intention

Identify barriers to vaccination

Third Party Report Data Sources

Input Cadence Sources Tactics for Utilization

Tanaq Social Listening 

+Media Monitoring 

Report

Weekly Meltwater

Sprout Social

First Draft

Native platform searches

Trending topics

Demographic and geographic 

conversation monitoring

CrowdTangle content 

insights report

Biweekly Facebook Top pages (voices), groups

General trends/sentiment 

analysis

News analysis through posts

Washington St. Louis 

iHeard

Weekly Proprietary methods Survey results

Emerging threats and data 

deficits

Vaccine narratives

Project VCTR Weekly Proprietary methods National and regional trends 

in negative attitudes toward 

vaccination

Conversations around Legislation