Parental Vaccine Hesitancy in Children With Comorbidities: A Comparative Analysis
Author(s)
Manuela Gschwend, PharmD, PhD1, Matthew Rousculp, MPH, PhD2, Jonathan Fix, PhD3.
1Senior Director RWE, NOVAVAX, Zürich, Switzerland, 2NOVAVAX, Cary, NC, USA, 3NOVAVAX, Gaithersburg, MD, USA.
1Senior Director RWE, NOVAVAX, Zürich, Switzerland, 2NOVAVAX, Cary, NC, USA, 3NOVAVAX, Gaithersburg, MD, USA.
OBJECTIVES: This review evaluated parental vaccine hesitancy (PVH) in children with chronic conditions and/or who are immunocompromised (CCIC) and compared rates of PVH to those in parents of healthy children. Given the heightened vulnerability for severe outcomes in CCIC to vaccine-preventable diseases, understanding and addressing PVH in this population is critical.
METHODS: A targeted search of PubMed and EMBASE up to 16 May 2025 identified studies that assessed PVH for general childhood and pediatric COVID-19 vaccines. CCIC included in the analysis were autism spectrum disorder (ASD), type 1 diabetes mellitus (T1DM), chronic liver diseases, kidney disease/hypertension, cancer and bone marrow transplants, multiple chronic conditions and immunocompromised states. Parental attitudes towards vaccination were evaluated using standardized instruments such as the Parent Attitudes about Childhood Vaccines scale and qualitative in-depth interviews.
RESULTS: Among the five studies that provided comparative data, parents of children with CCIC exhibited a nearly 50% higher average rate of vaccine hesitancy compared to parents of healthy children. Stratified analyses revealed statistically significant elevations in PVH for specific conditions, including T1DM (OR 3.3), ASD (OR 1.8), disability (OR 1.9), immunocompromised (OR 1.7), and visual disturbances/blindness (OR 3.2). Across all ten reviewed studies (including non-comparative designs), the overall weighted average prevalence of PVH in parents of CCIC was 25%, in contrast to 13% observed in parents of healthy children. Frequently cited reasons for hesitancy were fear of potential adverse events, concerns about vaccine ingredients, and perceived information deficits.
CONCLUSIONS: There is an observed higher prevalence of parental vaccine hesitancy among parents of CCIC compared to parents of healthy children, with variations observed across different health conditions. Targeted interventions emphasizing enhanced healthcare provider communication and condition-specific, evidence-based information are essential to address parental concerns and improve vaccine uptake in these vulnerable pediatric populations.
METHODS: A targeted search of PubMed and EMBASE up to 16 May 2025 identified studies that assessed PVH for general childhood and pediatric COVID-19 vaccines. CCIC included in the analysis were autism spectrum disorder (ASD), type 1 diabetes mellitus (T1DM), chronic liver diseases, kidney disease/hypertension, cancer and bone marrow transplants, multiple chronic conditions and immunocompromised states. Parental attitudes towards vaccination were evaluated using standardized instruments such as the Parent Attitudes about Childhood Vaccines scale and qualitative in-depth interviews.
RESULTS: Among the five studies that provided comparative data, parents of children with CCIC exhibited a nearly 50% higher average rate of vaccine hesitancy compared to parents of healthy children. Stratified analyses revealed statistically significant elevations in PVH for specific conditions, including T1DM (OR 3.3), ASD (OR 1.8), disability (OR 1.9), immunocompromised (OR 1.7), and visual disturbances/blindness (OR 3.2). Across all ten reviewed studies (including non-comparative designs), the overall weighted average prevalence of PVH in parents of CCIC was 25%, in contrast to 13% observed in parents of healthy children. Frequently cited reasons for hesitancy were fear of potential adverse events, concerns about vaccine ingredients, and perceived information deficits.
CONCLUSIONS: There is an observed higher prevalence of parental vaccine hesitancy among parents of CCIC compared to parents of healthy children, with variations observed across different health conditions. Targeted interventions emphasizing enhanced healthcare provider communication and condition-specific, evidence-based information are essential to address parental concerns and improve vaccine uptake in these vulnerable pediatric populations.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
RWD133
Topic
Epidemiology & Public Health, Patient-Centered Research, Real World Data & Information Systems
Disease
Pediatrics, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory), Vaccines