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Parental vaccine hesitancy greatest among group most severely affected by COVID-19

Although a study revealed vaccine hesitancy in a third of respondents, it was highest among the group most severely affected by the pandemic.

The US Centers for Disease Control and Prevention, has indicated that the risk of infection, hospitalisation and death from COVID-19 among US citizens is higher among ethnic minorities compared with their White counterparts. Although COVID-19 vaccines have significantly reduced the incidence of severe illness, hospitalisation and death, not everyone has embraced the need for COVID-19 vaccination. For example, in study vaccine hesitancy levels were 5-times higher in those of Black ethnicity compared to white individuals. Additionally, vaccine hesitancy is a recognised problem among parents, with a 2019 study showing that a quarter of parents reported hesitancy over childhood influenza vaccination. Demographic data in the US indicates that 22% of the population is under the age of 18 hence there is an urgent need to ensure that children receive a COVID-19 vaccine and therefore increase the levels of community protection against the virus.

Given the existence of vaccine hesitancy, a team from the Division of Advanced General Pediatrics and Primary Care, Ann & Robert H. Lurie Children’s Hospital, Chicago, US, sought to understand, through an online, cross-sectional survey, not only the levels of vaccine hesitancy but how this was influenced by ethnicity and sociodemographic factors. The survey was conducted with parents who had children under 18 years of age and captured information on demographics, race, family income and the type of child insurance (e.g., public or private) as well as sources of information on COVID-19 using a defined list such as friends/word of mouth, internet, social media etc. COVID-19 vaccine hesitancy was measured from the question, “if a new vaccine against COVID-19 became available, how likely would you be to get your child vaccinated?” Responses were dichotomised as vaccine amenable or vaccine hesitancy for those responding “not likely” or “not sure” and this served as the outcome of interest. In their regression analysis, the authors examined the association between hesitancy and ethnicity, adjusting for parental race, household income, child insurance type and sources of information in which parents reported confidence.


A total of 1425 usable responses were obtained with 40% self-reporting as non-Hispanic White, 24% non-Hispanic Black and 27% as Hispanic (any race). Overall, 33% of parents reported COVID-19 vaccine hesitancy for their child. This was highest among non-Hispanic Blacks (48%) and lowest among non-Hispanic Whites (26%). The most common source of information on COVID-19 was the internet (67%). The authors calculated that non-Hispanic Black respondents had a significantly higher odds of COVID-19 vaccine hesitancy for their children compared to non-Hispanic White parents (adjusted odds ratio, aOR = 1.75, 95% CI 1.28 – 2.39, p < 0.001). In addition, parents on the lowest income also had a higher odds of hesitancy (aOR = 2.86) as did those having public insurance for their child (aOR = 1.33).

In discussing their findings, the authors commented on how non-Hispanic Black parents, with lower incomes and public health insurance had the highest levels of vaccine hesitancy. They concluded that given how this demographic had been most adversely affected by the pandemic, efforts to improve the dissemination of information about the COVID-19 vaccine should be culturally tailored to reduce disease burden in theis patient group.


Alfieri NL et al. Parental COVID-19 vaccine hesitancy for children: vulnerability in an urban hotspot. BMC Public Health 2021

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