Parental Acceptance of COVID-19 Vaccines: A Big Hill to Climb

Reviewed by Zachary Willis, MD, MPH, UNC Health and Emily Thorell, MD, MSCI, University of Utah School of Medicine

Szilagyi et al used the Understanding America Study, a representative Internet panel of the US population, to survey 1745 parents representing 3759 children regarding their perceptions and intentions of COVID-19 vaccination for their children; the survey occurred during February and March 2021. In response to the question, “If a vaccine against the coronavirus becomes available for children, do you plan to get [child’s name] vaccinated?” only 48% responded “yes,” including 23% who responded “yes, wait and see.” Unsurprisingly, parents’ intentions for themselves were the strongest predictor of their intentions for their children: 75% of those intending to get a vaccine for themselves reported intent to have their children vaccinated, compared to only 10% of those who were not intending to be vaccinated themselves. Other important factors positively associated with intent to vaccinate children included: greater educational attainment, older age of child, and identifying as a Democrat.

As the delta variant has caused a wave of pediatric illness and hospitalizations since the survey was conducted, the findings of the current study are alarming. Children under age 18 represent roughly 22% of the US population, and fewer than 42% of adolescents aged 16-17 and 34% of those aged 12-15 are fully vaccinated. On September 20th, Pfizer and BioNTech announced preliminary encouraging safety and immunogenicity data for their COVID-19 in children between the ages of 5 and 11; authorizations in children are likely coming soon. It will be interesting to see if these intentions change over time as vaccines are increasingly politicized but the risk of remaining unvaccinated rises. School-entry vaccine mandates have shown that vaccination coverage far exceeding 90% is possible; seasonal influenza vaccine coverage reminds us that such success is far from guaranteed.  Perhaps the most important finding is that the most trusted source of information about vaccines for children is the children’s own health care provider, suggesting an important strategic direction for vaccine advocates.


  1. Szilagyi PG, Shah MD, Delgado JR, et al. Parents’ Intentions and Perceptions About COVID-19 Vaccination for Their Children: Results From a National Survey. Pediatrics. Published online October 1, 2021. doi:10.1542/peds.2021-052335
  2. Pfizer and BioNTech Announce Positive Topline Results From Pivotal Trial of COVID-19 Vaccine in Children 5 to 11 Years | Pfizer. Accessed September 20, 2021. 
  3. US Coronavirus vaccine tracker. Published September 20, 2021. Accessed September 20, 2021. 
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