SARS-CoV-2 vaccination intentions among mothers of children aged 9 to 12 years: a survey of the All Our Families cohort

Erin Hetherington; Sarah A. Edwards; Shannon E. MacDonald; Nicole Racine; Sheri Madigan; Sheila McDonald; Suzanne Tough

doi:10.9778/cmajo.20200302

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Figure 1:
Factors influencing intention to vaccinate among mothers of children aged 9 to 12 years, derived from thematic analysis of open text survey responses from 84.9% of participants (n = 1122).

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Table 1:

Characteristics of mothers who participated in a survey on the impact of COVID-19

Characteristic	No. (%) of mothers
Characteristic	Overall n = 1321^*	Intended to vaccinate n = 798	Did not intend to vaccinate n = 113	Unsure n = 410
Maternal age, yr, mean ± SD	42.2 ± 4.4	42.5 ± 4.1	41.9 ± 4.7	41.5 ± 4.7
Range, yr	28–57
Maternal education (high school or less)^†	236 (17.9)	106 (13.3)	34 (30.1)	96 (23.5)
Family income before COVID-19 (< $80 000)^*^‡	198 (15.1)	97 (12.8)	29 (26.1)	72 (17.7)
Marital status (single, divorced, separated or widowed)^*^§	69 (5.5)	42 (5.5)	7 (6.4)	20 (5.1)
Ethnicity (self-identified minority)^*^¶	221 (16.8)	132 (16.6)	20 (19.9)	69 (17.0)
Child vaccine history (partially or not vaccinated)^**	200 (15.1)	102 (12.8)	33 (29.2)	65 (15.9)
SARS-CoV-2 infection in household (yes or maybe)^††	80 (6.1)	54 (6.8)	7 (6.2)	19 (4.7)

Note: DTaP = diphtheria, tetanus, acellular pertussis; Hib = Haemophilus influenzae type b; IPV = inactivated polio vaccine; MMRV = measles, mumps, rubella and varicella; Ref. = reference category; SD = standard deviation.
↵* Slight variation in the denominator from missing data on income, marital status or ethnicity (< 1%).
↵† Ref: some postsecondary, completed college, undergraduate or higher.
↵‡ Ref: family income ≥ $80 000 — cut-off based on when a family of 4 becomes eligible for subsidized rental in Calgary. (28)
↵§ Ref: married or common-law.
↵¶ Ref: self-identified White; minority category aggregated due to small numbers in distinct minority groups.
↵** Ref: complete vaccines at 2 years (DTaP-IPV-Hib, pneumococcal conjugate, meningococcal conjugate and MMRV).
↵†† Ref: not infected.

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Table 2:

Odd ratios from multinomial models for mothers reporting their intention to have their child receive the SARS-CoV-2 vaccine

Characteristic	OR (95% CI)^*
Characteristic	No v. yes	Unsure v. yes
Maternal age	0.97 (0.93–1.01)	0.94 (0.92–0.97)
Maternal education (high school or less)^†	2.80 (1.78–4.40)	1.98 (1.47–2.71)
Family income (< $80 000)^‡	2.53 (1.58–4.06)	1.53 (1.10–2.14)
Marital status (single, divorced, separated or widowed)^§	1.16 (0.51–2.66)	0.91 (0.53–1.58)
Ethnicity (self-identified minority)^¶	1.09 (0.65–1.83)	1.02 (0.74–1.41)
Child vaccine history (partially or not vaccinated)^**	2.81 (1.78–4.40)	1.29 (0.92–1.80)
SARS-CoV-2 infection (yes or maybe)^††	0.91 (0.40–2.05)	0.67 (0.39–1.15)

Note: CI = confidence interval, OR = odds ratio, Ref. = reference category, SD = standard deviation.
↵* All ORs represent bivariate associations and are unadjusted for other factors.
↵† Ref: completed college, undergraduate or higher.
↵‡ Ref: family income (≥ $80 000).
↵§ Ref: married or common-law.
↵¶ Ref: self-identified White.
↵** Ref: complete vaccines at 2 years.
↵†† Ref: not infected.

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Table 3:

Quotes for qualitative categories

Factor	Quotes^*
Safety and efficacy	“The effectiveness of the vaccine is key to consider and any side effects.” Participant 1175 (unsure) “I believe in vaccinations so would lead toward vaccinating — but would need more scientific information before making the final decision.” Participant 1133 (unsure)
Vaccine confidence	“Would 100% vaccinate my family as soon as possible; we 100% support vaccinations.” Participant 155 (yes) “I believe in vaccines; I believe in science.” Participant 234 (yes)
Long-term safety	“Trial period will be too short to predict all possible long-term risks. If a few years, maybe consider, definitely not within 1–2 years.” Participant 74 (no) “I am hesitant to take a vaccine or have my child injected with a vaccine that is so new. I would be afraid of complications in future years that are now unknown.” Participant 995 (unsure)
Rushed process/scientific quality	“It’s safety. It seems like this vaccine is being rushed through trials.” Participant 1075 (unsure) “I trust medicine and science and have always vaccinated in the past; my only hesitancy with this vaccine would be the ‘desperation/rush’ that everyone is looking for a ‘cure/solution’ to COVID.” Participant 1201 (unsure)
Perception of personal risk	“I am immune compromised so the family will be getting it to protect my health.” Participant 411 (yes) “If we have any underlying health issues that would compromise our immune system.” Participant 968 (unsure) “I will not be receiving vaccine because I feel it’s useless to us; we are strong enough to get over this flu.” Participant 107 (no)
Recommendation from doctor or health authority	“The recommendation of the Public Health Agency of Canada.” Participant 158 (yes) “My doctor’s recommendation would be the only opinion I would use to make my decision about being vaccinated.” Participant 14 (no)
Perception of risk from COVID-19	“Risk of contracting COVID-19 would need to be greater than any risk associated to the vaccine.” Participant 30 (no) “How much of the virus is still going on and impacting society.” Participant 1150 (unsure)
Availability and cost	“Availability. I would pay for it if it was reasonable and available in my city.” Participant 910 (yes) “Availability and ease of access — I would not want to be standing in huge long lines for hours waiting for the vaccine like I did with H1N1.” Participant 442 (yes)
Attitude toward flu vaccine (both positive and negative)	“My child has had all of the childhood vaccines but our family does not obtain the influenza vaccine as I feel we are all very healthy.” Participant 996 (unsure) “Like the flu shot, is it really going to get the right strand of COVID-19?” Participant 1087 (unsure) “We get the flu shot each year to protect our family from the worst of the effects of the flu.” Participant 118 (yes)
Against vaccinations	“I would not get the vaccine or give it to my children. If there were any measures to make the vaccine mandatory or if people with the vaccine were given preferential treatment it would further solidify my stance to not get the vaccine. The other factor that would affect my decision is the overbearing influence on WHO, Health Canada/PHAC and AHS from corporate entities.” Participant 155 (no) “Nothing will impact or change my view to vaccinate. I will not vaccine anyone in my family.” Participant 100 (no)
Other (mandatory, family opinions)	“If it is mandatory for work and school.” Participant 1013 (unsure) “My ex-husband is not for vaccines. This will be my challenge.” Participant 789 (yes)

Note: AHS = Alberta Health Services, PHAC = Public Health Agency of Canada, WHO = World Health Organization.
↵* Vaccine intentions of participants noted in parentheses.