• Jannah Wigle, Kathryn Hodwitz, Clara Juando-Prats, Kate Allan, Xuedi Li, Lisa Howard, Barbara Fallon, Catherine S Birken, Jonathon L Maguire, and Janet A Parsons.
• Applied Health Research Centre (Wigle, Hodwitz, Juando-Prats, Maguire, Parsons), St. Michael's Hospital, Unity Health Toronto; Dalla Lana School of Public Health (Juando-Prats, Howard), University of Toronto; Factor-Inwentash Faculty of Social Work (Allan, Fallon), University of Toronto; Child Health Evaluative Sciences (Li, Birken), The Hospital for Sick Children; Departments of Pediatrics (Birken, Maguire) and of Occupational Science and Occupational Therapy (Parsons), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.
• CMAJ. 2023 Feb 21; 195 (7): E259E266E259-E266.

BackgroundUptake of the SARS-CoV-2 vaccine for children aged 5-11 years has been lower than anticipated in Canada. Although research has explored parental intentions toward SARS-CoV-2 vaccination for children, parental decisions regarding vaccinations have not been studied in-depth. We sought to explore reasons why parents chose to vaccinate or not vaccinate their children against SARS-CoV-2 to better understand their decisions.MethodsWe conducted a qualitative study involving in-depth individual interviews with a purposive sample of parents in the Greater Toronto Area, Ontario, Canada. We conducted interviews via telephone or video call from February to April 2022 and analyzed the data using reflexive thematic analysis.ResultsWe interviewed 20 parents. We found that parental attitudes toward SARS-CoV-2 vaccinations for their children represented a complex continuum of concern. We identified 4 cross-cutting themes: the newness of SARS-CoV-2 vaccines and the evidence supporting their use; the perceived politicization of guidance for SARS-CoV-2 vaccination; the social pressure surrounding SARS-CoV-2 vaccinations; and the weighing of individual versus collective benefits of vaccination. Parents found making a decision about vaccinating their child challenging and expressed difficulty sourcing and evaluating evidence, determining the trustworthiness of guidance, and balancing their own conceptions of health care decisions with societal expectations and political messaging.InterpretationParents' experiences making decisions regarding SARS-CoV-2 vaccination for their children were complex, even for those who were supportive of SARS-CoV-2 vaccinations. These findings provide some explanation for the current patterns of uptake of SARS-CoV-2 vaccination among children in Canada; health care providers and public health authorities can consider these insights when planning future vaccine rollouts.© 2023 CMA Impact Inc. or its licensors.

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