Household Vaccination Status and Attitudes toward Pediatric COVID-19 Vaccination: A Survey at Four New Jersey Clinic-Based Pediatric Practices.

Despite the documented safety and efficacy of the COVID-19 vaccination, parental pediatric vaccine hesitancy is common. Little is known about the concerns and beliefs held by caregivers that impact COVID vaccination decision-making on behalf of their minor children, as underlying attitudes toward pediatric COVID-19 vaccination have not been well described. Unvaccinated children and their caregivers underwent antibody testing and completed an electronic survey at four clinic-based practices in Northern and Central New Jersey from August 2022 to June 2023. Caregivers were grouped into four attitudinal classes based on how safe, effective, useful, and necessary they believed COVID-19 vaccination were. Caregivers in the lowest vaccine acceptance classes (1 and 2) were significantly less likely to plan to vaccinate their children compared to those in the higher classes (3 and 4) (8.9% and 5.6% vs. 30.4% and 61%). Those in Class 2 were significantly less likely to have at least one adult household member fully vaccinated or boosted against COVID-19 than those in higher classes and marginally more likely to be from households where at least one adult had been diagnosed with COVID-19 in the past year than those in Class 3 (52% vs. 40%). The majority of caregivers viewed their pediatrician as a trusted source of information (89%). Caregiver attitudes toward vaccination are associated with household vaccination status and family COVID-19 infection history. Pediatricians play an important role in aiding vaccine uptake among children. Educational efforts should target differing caregiver profiles to address vaccine hesitancy and make future pediatric vaccine programming more successful.