Perspectives and involvement of children and adolescents during the decision-making process of their Covid-19 vaccination

Objective: This study aims to understand the perspectives of young people towards their Covid-19 vaccination and their involvement in the decision-making process.

Methods: Semi-structured interviews were conducted with 25 children and adolescents (aged 8-19 years), who attended a school in Germany during the pandemic. Interviews were explored with structured and evaluative content-analysis.

Results: Five overarching themes were identified: 1) Motivators for vaccination: protection against Covid-19, secondary societal benefits and positive experience of peers 2) Barriers to vaccination: perceived lack of risk for severe disease 3) Participation in the decision-making process: mostly adult-initiated shared decisions 4) Role of vaccination status at school: issues of marginalization and stigmatization 5) Wishes to adults and politicians: need for better information CONCLUSION: Involving children at a high level of participation while taking into account their individual maturity could be a favourable strategy in a family`s decision-making process regarding vaccination. Expectations from peers or parents and societal benefits as primary incentive to get vaccinated should be minimized during the decision-process.

Practice implications: Our study highlights the need to include young people`s perspectives in vaccine research, -development and -education campaigns. Future research should develop instruments to structurally embed and promote children and youth participation in healthcare-related decisions.