Alimoradi Zainab, Lin Chung-Ying, Pakpour Amir H
Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin 3415613911, Iran.
Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan.
Vaccines (Basel). 2023 Feb 24;11(3):533. doi: 10.3390/vaccines11030533.
Currently, the best method to well control the spread of COVID-19 without severe mental health problems is to reach herd immunity. Therefore, the vaccination rate of the COVID-19 vaccine is critical. Among the populations, children are the vulnerable ones to get vaccinated; therefore, it is important to assess parents' and guardians' willingness to have their children vaccinated. The present systematic review and meta-analysis synthesized evidence to estimate the parents' acceptance rate of COVID-19 vaccination toward their children. Additionally, factors explaining the acceptance rate were investigated. Four academic databases (PubMed, Scopus, Web of Science, and ProQuest) together with Google Scholar were searched, and the references of the included publications were searched as well. Using the PECO-S framework (population, exposure, comparison, outcome, and study design), observational studies of cross-sectional, cohort, or case-control studies were included. The outcome was parents' or guardians' willingness to let their children be vaccinated. The studies included in the present review were restricted to English and peer-reviewed papers published between December 2019 and July 2022. A total of 98 papers across 69 different countries with 413,590 participants were included. The mean age of the parents was 39.10 (range: 18-70) years and that of their children was 8.45 (range: 0-18) years. The pooled estimated prevalence of parental acceptance to vaccinate their children with the COVID-19 vaccine was 57% (98 studies, 95% CI: 52-62%, I: 99.92%, τ: 0.06). Moreover, data collection time was a significant factor explaining parental willingness in the multivariable meta-regression, with a 13% decrease in parental willingness by each month increase in time, explaining 11.44% of variance. Qualitative synthesis results showed that parents' COVID-19 vaccine knowledge, trust in theCOVID-19 vaccine, and facilitators in vaccination (e.g., low cost, good vaccine accessibility, and government incentive) were significant factors for higher willingness, while mental health problems (e.g., having worries and psychological distress) were significant factors for lower willingness. Given that the acceptance rate was relatively low (57%) and does not achieve the requirement of herd immunity (i.e., 70%), governments and healthcare authorities should try to elevate parents' knowledge and trust in the COVID-19 vaccine, facilitate in vaccination, and reduce their mental difficulties to improve the overall vaccination rate among children.
目前，在不引发严重心理健康问题的情况下，有效控制新冠病毒传播的最佳方法是实现群体免疫。因此，新冠疫苗的接种率至关重要。在人群中，儿童是接种疫苗的弱势群体；因此，评估父母和监护人让孩子接种疫苗的意愿非常重要。本系统评价和荟萃分析综合证据，以估计父母对其子女接种新冠疫苗的接受率。此外，还调查了解释接受率的因素。检索了四个学术数据库（PubMed、Scopus、Web of Science和ProQuest）以及谷歌学术，并检索了纳入出版物的参考文献。采用PECO-S框架（人群、暴露、对照、结局和研究设计），纳入横断面、队列或病例对照研究的观察性研究。结局是父母或监护人让其子女接种疫苗的意愿。本综述纳入的研究仅限于2019年12月至2022年7月期间发表的英文和同行评审论文。共纳入来自69个不同国家的98篇论文，涉及413590名参与者。父母的平均年龄为39.10岁（范围：18 - 70岁），其子女的平均年龄为8.45岁（范围：0 - 18岁）。父母接受其子女接种新冠疫苗的合并估计患病率为57%（98项研究，95%置信区间：52 - 62%，I：99.92%，τ：0.06）。此外，在多变量Meta回归中，数据收集时间是解释父母意愿的一个重要因素，时间每增加一个月，父母意愿下降13%，解释了11.44%的方差。定性综合结果表明，父母的新冠疫苗知识、对新冠疫苗的信任以及接种疫苗的促进因素（如低成本、良好的疫苗可及性和政府激励措施）是意愿较高的重要因素，而心理健康问题（如担忧和心理困扰）是意愿较低的重要因素。鉴于接受率相对较低（57%）且未达到群体免疫的要求（即70%），政府和卫生保健当局应努力提高父母对新冠疫苗的知识和信任，促进疫苗接种，并减少他们的心理困扰，以提高儿童的总体疫苗接种率。
