93 SARS-CoV-2 Vaccine Acceptance and Uptake among Caregivers of Children 5-11 Years of Age: A Cross-sectional Survey
Authors: Shahrbabak Elahe Karimi , Piché-Renaud Pierre-Philippe , Morris Shaun K , Farrar Daniel S , Peresin Joelle , Fadaleh Sarah Abu , Low Brooke , Avelar-Rodriguez David 
Published: September 2023

Abstract

Background
Although vaccination of children aged 5-11 years against SARS-CoV-2 is recommended in Canada, nearly half of Ontarian children this age remain unvaccinated.

Objectives
This study aimed to assess caregivers’ vaccine acceptance and uptake for children in this age group and to identify factors associated with vaccine non-acceptance in Ontario.

Design/Methods
A multi-language self-administered survey was sent to caregivers of children aged 5-11 years through schools and community health centres within the Toronto Area, from April 5th–July 4th, 2022. Socio-demographic characteristics, acceptance of routine childhood and influenza vaccines, and current SARS-CoV-2 vaccine status for parents and older siblings were collected. Data were analyzed using descriptive statistics and multivariable logistic regression.

Results
Overall, 807 caregivers of children aged 5-11 years answered the survey. Although 748 (93%) caregivers had received at least two doses of COVID-19 vaccine, only 618 (77%) had a child 5-11 years old who had received at least one dose of the vaccine. Adjusted odds ratios for vaccine acceptance were higher among caregivers older than 40 years of age, caregivers who were vaccinated against COVID-19 themselves, children living in areas with high vaccine coverage, and children who received at least one influenza vaccine in the past two years (see Figure 1, below). Caregivers reported seeking information on COVID-19 mostly from public health resources (76%), government organizations (58%), social media (58%), and family doctors or paediatricians (38%). The most common reasons among caregivers not to vaccinate children were concerns about long-term side effects (59%), wanting to wait until there is more experience with vaccinating children (41%), and concerns that vaccines were developed too quickly (39%) (Figure 2).

Conclusion
We describe factors associated with SARS-CoV-2 vaccine non-acceptance in caregivers of children 5-11 years old and the barriers to vaccine acceptance in this population. These findings provide insights on groups of caregivers that should be targeted for educational and public health interventions and identify parental concerns that ought to be addressed to increase vaccine confidence.

Potential competing interests
Dr. Shaun K. Morris has received honoraria for lectures from GlaxoSmithKline, was a member of ad hoc advisory boards for Pfizer Canada and Sanofi Pasteur, and is an investigator on an investigator-led grant from Pfizer, all unrelated to this study. This project is supported by a grant from the Public Health Agency of Canada’s Immunization Partnership Fund.

1The number of 668 cases were included in the model.2Caregivers were able to select multiple choices for their ethnicity, and Indigenous ethnic background was classified as mixed and other.3Children received at least one influenza vaccine in the past two years.4Vaccination coverage was based on the Forward Sortation Area from the Institute for Clinical Evaluative Sciences July 2022.

1187 caregivers of unvaccinated children against COVID-19 included and could choose multiple reasons not to vaccinate their children 5-11 years of age.