• Lucas de Brito Costa, Carolina Nunes França, Luiz Henrique da Silva Nali, Patrícia Colombo-Souza, Neil Ferreira Novo, and Yára Juliano.
• Master's student, Postgraduate Program in Health Sciences, Universidade de Santo Amaro (UNISA), São Paulo, Brazil.
• Sao Paulo Med J. 2024 Jan 1; 142 (6): e2023447e2023447.

BackgroundVaccination hesitation spans from historical diseases such as smallpox to the current challenges with the coronavirus disease (COVID-19). In Brazil, vaccination faces obstacles related to trust and convenience. Despite the National Immunization Program, fear of adverse effects as well as misinformation challenge confidence in vaccines, and anti-vaccine movements have gained momentum.ObjectivesThis study investigated childhood vaccine refusal, including COVID-19 vaccines, by comparing the reasons for and sociodemographic differences between vaccinated individuals and those who hesitated or refused immunization.Design And SettingA cross-sectional study was conducted in São Paulo, Brazil, using questionnaires administered during pediatric consultations between January and April 2023.MethodsThis study investigated vaccine hesitancy and the attitudes of parents and caregivers of children (0-12 years) towards vaccines. The questionnaire was administered during routine pediatric consultations at three different locations, each with 50 participants for a total of 150 participants, to avoid selection bias.ResultsMarked differences were evident among caregivers in terms of sex, race, income, education, and religion, which influenced their attitudes toward vaccination. There was an increase in the refusal of seasonal vaccinations and a significant distrust of the efficacy of the COVID-19 vaccine (52%), with concerns about its side effects. Although most patients did not stop vaccination, significant delays occurred, especially in the clinical setting (58%).ConclusionsThis study emphasizes the importance of childhood health decisions, indicating the need to build trust in vaccines, tailor health policies, and investigate the causes of distrust to promote childhood immunizations.

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