Willingness and influential factors of parents to vaccinate their children against the COVID-19: a systematic review and meta-analysis

Galanis, P.; Vraka, I.; Siskou, O.; Konstantakopoulou, O.; Katsiroumpa, A.; Kaitelidou, D.

Background: Coronavirus disease 2019 (COVID-19) vaccine uptake among children will be critical in limiting the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the disease. Parents are key decision-makers for whether their children will receive a COVID-19 vaccine. Objective: To estimate parents willingness to vaccinate their children against the COVID-19, and to investigate the predictors for their decision. Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines for this systematic review and meta-analysis. We searched Scopus, Web of Science, Medline, PubMed, ProQuest, and CINAHL from inception to August 11, 2021. The review protocol was registered with PROSPERO (CRD42021273125). We applied a random effect model to estimate pooled effects since the heterogeneity was very high. We used subgroup analysis and meta-regression analysis to explore sources of heterogeneity. Results: We found 17 studies including 45,783 parents. The overall proportion of parents that intend to vaccinate their children against the COVID-19 was 56.8% (95% confidence interval: 51.8-61.8%). Parents willingness ranged from 29% to 72.7%. Studies quality, sample size, data collection time, and the continent that studies were conducted did not affect the results. The main predictors of parents intention to vaccinate their children against COVID-19 were male gender, older age of parents and children, higher socio-economic status, white race, positive attitudes toward vaccination, higher levels of knowledge, and higher levels of perceived threat from the COVID-19, worry, fear, and anxiety. Conclusions: Parents willingness to vaccinate their children against the COVID-19 is moderate and several factors affect this decision. Understanding parental COVID-19 vaccine hesitancy does help policymakers to change the stereotypes and establish broad community COVID-19 vaccination. Identification of the factors that affect parents willingness to vaccinate their children against COVID-19 will provide opportunities to enhance parents trust in the COVID-19 vaccines and optimize children uptake of a COVID-19 vaccine.