Canadian parents' perceptions of COVID-19 vaccination and intention to vaccinate their children: Results from a cross-sectional national survey

Background: Vaccinating children (≤17 years old) is important for controlling the COVID-19 pandemic. As parents are primary decision makers for their children, we aimed to assess parents' perceptions and intentions regarding COVID-19 vaccination for their children, including for some underserved populations (e.g., newcomers, Indigenous peoples, and visible minority groups).

Methods: We conducted a cross-sectional national survey of Canadian parents in December 2020, just as COVID-19 vaccines were approved for adults, to assess intention to vaccinate their children (aged 0-17 years) against COVID-19, perceptions of COVID-19 disease and vaccines, previous uptake of influenza and routine vaccines, and sociodemographic characteristics. Binomial logistic regression was used to assess the association between parents' lack of COVID-19 vaccination intention for their children and various independent variables.

Results: Sixty-three percent of parents (1074/1702) intended to vaccinate their children against COVID-19. Those employed part-time (compared to full-time) had lower intention to vaccinate their children (aOR = 1.73, 95% CI: 1.06-2.84), while those who spoke languages other than English, French, or Indigenous languages were less likely to have low intention (aOR = 0.55, 95% CI: 0.32-0.92). Low vaccination intention was also associated with children not receiving influenza vaccine pre-pandemic (aOR = 1.51, 95% CI: 1.04-2.21), parents having low intention to vaccinate themselves against COVID-19 (aOR = 9.22, 95% CI: 6.43-13.34), believing COVID-19 vaccination is unnecessary (aOR = 2.59, 95% CI: 1.72-3.91) or unsafe (aOR = 4.21, 95% CI: 2.96-5.99), and opposing COVID-19 vaccine use in children without prior testing (aOR = 3.09, 95% CI: 1.87-5.24).

Interpretation: Parents' COVID-19 vaccination intentions for their children are better predicted by previous decisions regarding influenza vaccination than routine childhood vaccines, and other perceptions of COVID-19 vaccine-related factors. Public communication should highlight the safety and necessity of COVID-19 vaccination in children to support a return to normal activities. Further research should assess actual COVID-19 vaccination uptake in children, particularly for underserved populations.