49 Systematic Review and Meta-analysis of SARS-CoV-2 Vaccine Acceptance in Parents of Children Aged 5-11

Abstract Background Despite the well-studied benefits and safety of SARS-CoV-2 vaccines, many caregivers of children aged 5 to 11 years old remain hesitant to have their child vaccinated. Reasons for vaccine non-acceptance and barriers specific to children aged 5-11 and caregivers are poorly understood. Objectives Our study aims to: 1) Assess proportion of parents who are acceptant of vaccines in different populations/settings; 2) Identify parent and children characteristics associated with vaccine acceptance; and 3) Identify reasons for vaccine non-acceptance. Design/Methods Medline, Embase, Cochrane and CINAHL were searched using predefined search terms to identify relevant studies published between October 29, 2021 and September 12, 2022. Studies were assessed for inclusion/exclusion by two authors, and discrepancies were resolved by discussion with a senior author. Random-effects meta-analysis was performed to estimate the pooled proportion of parents who are acceptant of SARS-CoV-2 vaccines. Results A total of 1571 articles were identified for full text review, of which 30 were included. Twenty-four studies were conducted in high income countries, three in upper middle-income countries and three in low- to middle-income countries. The pooled effects size for vaccine acceptance in caregivers of children aged 5-11 years was calculated as 54% (95% confidence interval 47–60%), with considerable between-study heterogeneity (I2 of 99.04%). Characteristics associated with vaccine acceptance included caregivers being vaccinated against SARS-CoV-2 themselves, and higher parental education. Common reasons for vaccine non-acceptance consisted of vaccine safety/efficacy concerns and perception children being less susceptible to SARS-CoV-2 infection compared with adults. Conclusion The overall proportion of caregivers being acceptant of SARS-CoV-2 vaccine for their child aged 5-11 was found to be low, with the main barriers relating to vaccine safety concerns and health education. Further studies exploring these barriers and potential solutions to increase vaccine confidence and uptake in this age group are needed.