The pandemic's role in shaping parents' attitudes toward vaccines

A vaccine.

Q&A with Abram L. Wagner

Assistant Professor, Epidemiology

The COVID-19 pandemic influenced parent’s attitudes and feelings toward vaccinating their children, according to a recent study conducted by University of Michigan School of Public Health researchers. The researchers say examining the impact of the COVID-19 pandemic on parental vaccine hesitancy provides valuable information and insight into Americans' sentiments on vaccinating their children, in addition to determining targeted and effective programs and interventions to increase vaccine uptake.

This is just one of several recent research studies demonstrating the pandemic’s effect on overall vaccine hesitancy. In November 2023, the Centers for Disease Control and Prevention released a report which found that nationwide vaccination coverage for kindergarteners was below pre-pandemic levels. Public health officials attributed the decrease in vaccination rates in this population to doubts about COVID-19 vaccines.

Abram L. Wagner, an assistant professor of Epidemiology and Global Public Health at Michigan Public Health and senior author of the study, discusses the work, which was published in the journal Vaccine. Wagner’s research interests include documenting how attitudes toward vaccination change over time and how vaccine hesitancy relates to vaccination behaviors.

What did your study look at?

We hypothesized that, with the rollout of the COVID-19 vaccine, some parents would have become more hesitant toward other pediatric vaccines.

In summer 2022, we surveyed parents with children ages 0-17 and found:

  • 11% believed that childhood vaccines are less safe compared to before the pandemic
  • 12% believed that childhood vaccines are less important compared to before the pandemic
  • 13% believed that childhood vaccines are less effective compared to before the pandemic

Belief that vaccines are less effective was also more common among parents who lived in areas with low COVID-19 vaccination coverage. Overall, this hints at growing polarization of attitudes toward vaccination.

What are the biggest takeaways from the study’s findings? How have parental beliefs changed since the pandemic?

First, more parents state that they have more positive beliefs about vaccines now than before the pandemic than parents who have more negative beliefs. It’s easy to hear stories from traditional and social media of individuals who have strongly negative attitudes about vaccines. However, we highlight that overall vaccination beliefs may have become more positive as a result of the COVID-19 vaccine roll-out. That’s a success!

Related, we found that people’s experiences during the pandemic affected their beliefs about childhood vaccines. For instance, parents who had a severe case of COVID-19 themselves thought childhood vaccines as a whole were less effective. And being in a community with low COVID-19 vaccination coverage or having friends and family with low COVID-19 vaccination uptake was also strongly related to believing childhood vaccines were less effective.

What this means is that if people have strong beliefs about not getting vaccines for themselves or for their children, vaccine providers could start further conversations about any specific experiences they’ve had with COVID-19 or other vaccine-preventable diseases.

Can you speak to the importance of this type of data collection to inform new or modified intervention strategies in light of COVID-19 vaccine sentiments?

Studies like this one speak to the need to be very careful about how we introduce new vaccines into a population. Negative attitudes toward one vaccine could generalize to negative attitudes toward vaccines in general.

There is more and more research being conducted on how to increase vaccine uptake in diverse populations—this includes experiments on the use of text messaging, increasing convenience of vaccination, and communication strategies like motivational interviewing. It will likely be very important to figure out if there are any large differences in how this works across vaccines and in various populations.

However, we do already know that one of the largest predictors of vaccination is a strong recommendation from a trusted health care provider. So as we gain evidence that perhaps can help with small details, it is most important to have a base of doctors, nurses, pharmacists, and other trusted health care professionals who can provide recommendations about vaccines.

As we gain a better understanding of the COVID-19 pandemic’s influence on childhood vaccination rates and attitudes on vaccination, what strategies do you think will be effective at mitigating hesitancy?

What we are realizing is that there are a lot of complexities to vaccine hesitancy. Having a positive, or even neutral, experience getting vaccinated could build momentum toward greater openness to getting vaccinated. This means we need to build in more time to talk about vaccines. 

It could be important to kickstart some of these conversations during pregnancy, before a child is born. Talking with pregnant individuals about vaccines they could get, and what their plans are once the child is born, could help prevent some problems in getting vaccinated later on. Some maternal care providers already provide this information. However, widespread implementation of vaccine communications during pregnancy could require us to rework how we bill for certain medical visits, and it means that our health care workforce needs to be given adequate time to have difficult conversations with parents.

Study cited: “The impact of the COVID-19 pandemic on parental vaccine hesitancy: A cross-sectional survey


Destiny CookDestiny Cook

Senior Public Relations Specialist
University of Michigan School of Public Health