Health Belief Model and parents' acceptance of the Pfizer-BioNTech and Sinopharm COVID-19 vaccine for children aged 5–18 years Old: A national survey

BACKGROUND: During the COVID-19 pandemic, several vaccines received approval for children aged 18 or younger. Parents’ decisions to accept vaccines play an important role in the success of vaccination campaigns. The Health Belief Model (HBM) may explain its association with vaccine acceptance. This study examined parents’ Pfizer-BioNTech and Sinopharm vaccine acceptance for their children and its association with HBM. METHODS: A cross-sectional study was conducted in March 2022 using an online survey. Respondents were parents of children aged 5–18 in public and private schools. The multistage random sampling technique was used to choose schools and respondents. Multivariable analysis was conducted to examine the association between vaccine acceptance and HBM. RESULTS: The response rate was 55 %. Of 1,056 respondents, 80.1 % were female, with a mean age of 41, and 95.8 % were not health professionals. Pfizer-BioNTech had a greater acceptance rate than Sinopharm (90 % v.s. 36 %). The Multivariable analysis shows that perceived benefits (aOR = 25.30, 95 %CI = 10.02–63.89 and aOR = 17.94, 95 %CI = 9.56–33.66 for Pfizer-BioNTech and Sinopharm, respectively) and perceived barriers (aOR = 0.06, 95 %CI = 0.01–0.50 and aOR = 0.20, 95 %CI = 0.11–0.40 for Pfizer-BioNTech and Sinopharm, respectively) were associated with vaccine acceptance for both vaccines. Education was associated with Pfizer-BioNTech vaccine acceptance (aOR = 0.96, 95 %CI 0.71–1.29). CONCLUSIONS: The respondents were more confident in Pfizer-BioNTech than Sinopharm. Perceived barriers and perceived benefits were strongly associated with the respondents’ vaccine acceptance for both vaccines. During epidemics and pandemics, the government needs vaccines with high efficacy and safety for a higher chance of parents’ vaccine acceptance. Future research should examine vaccine costs as perceived barriers for a newly out-of-pocket developed vaccine.