London School of Hygiene & Tropical Medicine

Nine out of ten parents and guardians in England would likely accept a COVID-19 vaccine for themselves (90%), and their children (89%), suggests new research published in Vaccine. 

The research team, led by the London School of Hygiene & Tropical Medicine, used a multi-methods approach – involving an online cross-sectional survey and interviews – to find out parents’ and guardians’ views on a future COVID-19 vaccine.  

1,252 parents and guardians (aged 16+ years) who reported living in England with a child aged 18 months or under completed the survey. Nineteen survey respondents were interviewed. 

Respondents were asked ‘If a new coronavirus (COVID-19) vaccine became publicly available would you accept the vaccine for yourself?’ 55% said ‘definitely’, 34.3% said ‘unsure but leaning towards yes’. When asked if they would accept a vaccine for their child/children,48.2% said ‘definitely’, 40.9% ‘unsure but leaning towards yes’. 

Less than 4% of respondents reported that they would definitely not accept a COVID-19 vaccine for themselves or their child/children. 

Respondents who were asked to self report and chose Black, Asian, Chinese, Mixed or Other ethnicity, were almost three times more likely to say they would reject a COVID-19 vaccine for themselves and their children than respondents who were asked to self report and chose White British, White Irish and White. 

Respondents in the lower household income bracket (<£35,000) were approximately twice as likely to reject a COVID-19 vaccine for themselves than respondents with a medium household income (£35,000-£84,999). Those in the highest income bracket (>£85,000) were almost three times as likely to accept the vaccine for themselves as middle-income bracket respondents. 

Respondents in the lower household income bracket were nearly twice as likely to reject a COVID-19 vaccine for their child than respondents with a medium household income. 

Dr Sadie Bell, Research Fellow at LSHTM and lead author said: “COVID-19 vaccines will be key to controlling this pandemic. Encouragingly, It’s looking likely that one will be available in 2021. However, having a vaccine doesn’t mean people will take it - vaccine hesitancy is a multi-faceted and complicated issue. 

“To prevent inequalities in uptake, it is crucial to understand and address factors that may affect COVID-19 vaccine acceptability in ethnic minority and lower-income groups who are disproportionately affected by COVID-19.” 

The survey revealed the main motivation for vaccine acceptance was for self-protection from COVID-19. Other reasons were to protect others, including family members and someone known to them in a risk group for COVID-19, and to stay safe to look after their children. 

Common concerns underpinning vaccine refusal were around COVID-19 vaccine safety and effectiveness, which were largely prompted by the newness and rapid development of the vaccine. 

Some survey participants expressed a lack of benefit to vaccinating their children, citing that children are hardly affected, are at lower risk of severe COVID-19 infection than adults, and less likely to catch or transmit COVID-19. 

Study co-author Dr Pauline Paterson, Assistant Professor at LSHTM and co-director of the Vaccine Confidence Project, said: “While it is great to see that most parents and guardians would accept a COVID-19 vaccine, our research has revealed worrying disparities. We know ethnic minority and lower-income groups are disproportionally affected by COVID-19, so it’s imperative that health officials focus on strategies to boost vaccine confidence in these communities. 

“Communication is key. Parents and guardians must be supported to understand the benefits of children being vaccinated, such as protecting grandparents and older relatives.To alleviate concerns, information on how COVID-19 vaccines are developed and tested, including their safety and efficacy, should be described clearly to the public. How the public reacts to a COVID-19 vaccine will be crucial to save lives and livelihoods over the coming years.” 

The authors acknowledge limitations of their study, including that parents and guardians were asked to express their intentions to vaccinate when we do not yet have an available COVID-19 vaccine.  It is difficult for parents and guardians to answer questions on the acceptability of a COVID-19 vaccine with so many unknowns about a future vaccine, including how effective a COVID-19 vaccine will be in different population groups. 

The National Institute for Health Research (NIHR) funded this study as part of the Health Protection Research Unit in Vaccines and Immunisation. The Health Protection Research Unit in Vaccines and Immunisation is a research partnership between the London School of Hygiene & Tropical Medicine and Public Health England, in collaboration with the University of Cambridge.

Publication 

Sadie Bell, Richard Clarke, Sandra Mounier-Jack, Jemma L. Walker, Pauline Paterson. Parents’ and guardians’ views on the acceptability of a future COVID-19 vaccine: A multi-methods study in England. Vaccine. DOI:10.1016/j.vaccine.2020.10.027