P3.P309: Parental Influenza Vaccine Hesitancy During and After the COVID-19 Pandemic

Background: Studies evaluating parental hesitancy regarding childhood influenza vaccine during and after the COVID-19 pandemic are scant. In this study, we evaluate parents’ attitudes toward the influenza vaccine before and after the COVID-19 pandemic. We also investigate the reasons behind influenza vaccine hesitancy and look for correlation between demographic factors and vaccine hesitancy.

Methods: An anonymous REDCap survey available in both English and Spanish was distributed to parents/caregivers in an outpatient pediatric clinic (UC Irvine Santa Ana) and in an inpatient pediatric unit (Children’s Hospital of Orange County) from September 2020 through January 2024. The survey collected demographic information, opinion toward the influenza vaccine, and reasons for vaccine hesitancy. Parents rated these reasons as important factors in their decision via a 4-point Likert scale ranging from “not a factor” to “an important factor”. Chi square analysis was used to compare vaccine hesitancy among different groups.

Results: Of 223 parents/caregivers, 184 (82.5%) completed the survey. Of these, 121 (65.8%) were of minority ethnicity (Black and Hispanic); 129 (70.1%) had an annual household income of 100,000 or less; 112 (60.9%) had less than an Associate’s degree; and 63 (34.2%) were unmarried. None of these demographic factors was found to significantly correlate with influenza vaccine hesitancy. The only statistical difference found was between the proportion of parents opposed to the influenza vaccine during the COVID-19 pandemic (13.0%) compared to after the pandemic (30.0%) (p=0.049) as seen in Figure 1. Although there was a change in influenza vaccine hesitancy during and after the pandemic, we did not find any significant differences in vaccine hesitancy among different socioeconomic groups. The reasons for vaccine hesitancy most rated by parents as either “somewhat of a factor” or “an important factor” were: “I am concerned about the side effects” (42.4%); “I don’t believe it is effective” (30.0%); and “I think it causes influenza illness” (26.3%) as seen in Figure 2. Our study has some limitations. First, due to its small sample size we could not make meaningful comparisons among subgroups. Second, our findings may not be generalizable to other populations as it was a single center study with the majority of the population belonging to minority groups and low-income families.

Conclusion: Our study did not find a significant correlation between vaccine hesitancy and demographic factors. However, the proportion of parents opposed to the influenza vaccine during the COVID-19 pandemic was significantly less than the proportion of parents opposed after the pandemic. Our study emphasizes the need for continuation of vaccination campaigns targeting populations with low vaccination rates. Larger studies with a focus on socioeconomic disparities are warranted to investigate parental influenza vaccine hesitancy.