The impact of pediatric influenza and COVID-19 hospitalization on parental attitudes toward vaccination.

Hospitalization for vaccine-preventable infections may influence parental vaccination attitudes, but comparative data for influenza and COVID-19 are limited. We conducted a multicenter observational study of unvaccinated children hospitalized with influenza or COVID-19 in Poland. We collected clinical data and parental survey data assessing vaccination regret, future vaccination intentions, willingness to encourage others, interest in vaccination reminders, reasons for non-vaccination, and sources of influence. Parents of influenza-hospitalized children reported greater regret over non-vaccination (62.5% [45/72] vs. 23.8% [15/63]), higher intention to vaccinate in the next season (58.3% [42/72] vs. 15.9% [10/63]), and willingness to encourage other parents to vaccinate (66.7% [48/72] vs. 36.5% [23/63]) than parents of COVID-19-hospitalized children. Multivariate analysis showed influenza hospitalization independently associated with parental regret (OR = 5.5, 95% CI: 2.2-14.0), intention to encourage others to vaccinate children (OR = 3.9, 95% CI: 1.6-9.7), and willingness to vaccinate next season (OR = 9.3, 95% CI: 3.3-26.7), but not interest in receiving vaccination reminder. In the COVID-19 group, more parents wanted vaccination reminders than planned vaccination (41.3% [26/63] vs. 15.9% [10/63]), suggesting openness to further engagement. In this group, regret and vaccination willingness were associated with comorbidities, rural residence, longer hospital stay, and higher C-reactive protein levels. In the influenza cohort, pneumonia was associated with changes in vaccination attitudes. Vaccine refusal was mainly driven by safety and effectiveness concerns for COVID-19 and disease trivialization for influenza. Pediatric influenza hospitalization may provide an opportunity to improve parental vaccination attitudes in the investigated sociocultural context, warranting further studies on targeted post-hospitalization interventions.