Parental Decision Making Regarding COVID-19 Vaccines for Children under Age 5: Does Decision Self-Efficacy Play a Role?

Background: COVID-19 vaccines are now available under Emergency Use Authorization for children ages 6 months to 5 years. We examined parents’ intentions to vaccinate their children under the age of 5 years and assessed whether their confidence in making an informed decision about vaccination (decision self-efficacy) was associated with these intentions. Method: We conducted a cross-sectional online survey of U.S. parents between 23 March and 5 April 2022. We examined associations between parental intention to vaccinate their young children (<age 5 years) and confidence in vaccine decision making (decision self-efficacy). A multivariable multinomial logistic regression model was used to obtain adjusted odds ratios (AORs) and 95% confidence intervals (CIs) of parental intention (categorized as intend to vaccinate, unsure, or do not intend to vaccinate). Results: Of the 591 parents in this sample, 49% indicated that they intended to vaccinate their child(ren), 29% reported that they would not, and 21% were undecided. In bivariate analyses, race/ethnicity, health insurance, flu vaccination in the past 12 months, and parental COVID-19 vaccination status were significantly related to parental intention to vaccinate their child(ren). In the multivariable analyses, which controlled for these factors, parents who intended to vaccinate their child(ren) had greater confidence in their ability to make informed decisions about COVID-19 vaccinations compared to those who were unsure about vaccination. Each one standard deviation in the Decision Self-Efficacy score was associated with a 39% increase in intention to vaccinate one’s child versus being unsure about vaccination (AOR 1.39, 95% CI 1.09, 1.77). Conclusions: Parents who are unsure about vaccinating their children against COVID-19 may benefit from interventions designed to increase their ability to obtain, understand, and utilize information to make informed decisions.