Vaccine Attitudes and COVID-19 Vaccine Intention Among Parents of Children With Kidney Disease or Primary Hypertension

Rationale & Objective: Children with kidney disease and primary hypertension may be more vulnerable to COVID-19. We examined COVID-19 vaccine hesitancy among parents of children with chronic kidney disease or hypertension. Study Design: Sequential explanatory mixed-methods design; survey followed by in-depth interviews. Setting & Participants: Parents of children aged <18 years with kidney disease or primary hypertension within a large pediatric practice. Exposure: Parental attitudes toward general childhood and influenza vaccines assessed by the Vaccine Hesitancy Scale. Kidney disease classification, demographic and socioeconomic factors, experiences with COVID-19, COVID-19 mitigation activities and self-efficacy, and sources of vaccine information. Outcome: Willingness to vaccinate child against COVID-19. Analytical Approach: Analysis of variance (ANOVA) test to compare parental attitudes toward general childhood and influenza vaccina-tion with attitudes toward COVID-19 vaccination. Multinomial logistic regression to assess predictors of willingness to vaccinate against COVID-19. Thematic analysis of interview data to characterize influences on parental attitudes. Results: Of the participants, 207 parents completed the survey (39% of approached): 75 (36%) were willing, 80 (39%) unsure, and 52 (25%) unwilling to vaccinate their child against COVID-19. Hesitancy toward general childhood and influenza vaccines was highest among the unwilling group (P < 0.001). More highly educated parents more likely to be willing to vaccinate their children, while Black race was associated with being more likely to be unwilling. Rushed COVID-19 vaccine development as well as fear of serious and unknown long-term side effects were themes that differed across the parental groups that were willing, unsure, or unwilling to vaccinate their children. Although doctors and health care teams are trusted sources of vaccine information, perceptions of benefit versus harm and experiences with doctors differed among these 3 groups. The need for additional information on COVID-19 vaccines was greatest among those unwilling or unsure about vaccinating. Limitations: Generalizability may be limited. Conclusions: Two-thirds of parents of children with kidney disease or hypertension were unsure or unwilling to vaccinate their child against COVID-19. Higher hesitancy toward routine childhood and influenza vaccination was associated with hesitancy toward COVID-19 vaccines. Enhanced communication of vaccine information relevant to kidney patients in an accessible manner should be examined as a means to reduce vaccine hesitancy.

Automated summary

This study examined COVID-19 vaccine hesitancy among parents of children with chronic kidney disease or hypertension. The results showed that two-thirds of parents were unsure or unwilling to vaccinate their child against COVID-19. Additionally, hesitancy toward routine childhood and influenza vaccination was associated with hesitancy toward COVID-19 vaccines. Therefore, it is necessary to enhance communication of vaccine information relevant to kidney patients in an accessible manner to reduce vaccine hesitancy.