Survey of Attitudes Toward Vaccination Against SARS-COV-2 in Pediatric Patients with Heart Disease.

Since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Japan has offered free pediatric vaccination; however, coverage among children has remained low. Children with heart disease are considered to have a higher risk of developing coronavirus disease (COVID-19) complications. This study aimed to investigate the attitudes of caregivers toward SARS-CoV-2 vaccination in this population. A questionnaire survey was conducted at 16 medical facilities between October 2023 and January 2024 among caregivers of children with heart disease aged 1 to 19 years. A total of 1142 valid responses were analyzed. It was found that vaccination rates were higher among older children. Additional factors associated with vaccination included more advanced parental age, history of influenza vaccination, and physician recommendation. The most common reason for vaccine refusal was concern about side effects. Among children with congenital heart disease, those requiring interventions or undergoing the Fontan procedure showed higher vaccination rates. These participants were also more likely to have received a recommendation from their physician. These findings suggest that physicians did not uniformly recommend vaccination, but instead tailored their advice based on the disease severity and individual circumstances. This finding underscores the critical role of physician guidance in caregiver decision-making. Understanding such attitudes under uncertain conditions may help to inform communication strategies and policy development for future public health crises involving novel vaccines.