Parental Perceptions and Barriers towards Childhood COVID-19 Vaccination in Saudi Arabia : A Cross-Sectional Analysis

Introduction: The vaccination of children against Coronavirus disease (COVID-19) is a prime area of focus around the globe and is considered a pivotal challenge during the ongoing pandemic. This study aimed to assess parents ' intentions to vaccinate their children and the barriers related to pediatric COVID-19 vaccination. Methodology: An online web-based survey was conducted to recruit parents with at least one child under the age of 12 years from Saudi Arabia's Al-Jouf region. The parental intentions to vaccinate children were assessed via six items, while barriers against vaccination were assessed through seven items in validated study instrument. A 5-point Likert scale was used to record the responses of parents regarding both their intentions and barriers. Results: In total, 444 parents (28.41 +/- 7.4 years, 65% females) participated in this study. Almost 90% of parents were vaccinated against COVID-19 but only 42% of parents intended to vaccinate their children. The mean intention score was 2.9 +/- 1.36. More than one-third of study participants had no plan to vaccinate their children against COVID-19. The majority of the respondents agreed to vaccinate their children if vaccination was made compulsory by the government (relative index: 0.76, 73%). Out of seven potential barriers analyzed, concerns over vaccine safety and side effects were ranked highest (RII: 0.754), reported by 290 (65%) participants. In multivariate logistic regression, significant predictors of parental intention to vaccinate children were the increased education level of the parents (secondary education: OR = 3.617, p = 0.010; tertiary education: OR = 2.775, p = 0.042), COVID-19 vaccination status (vaccinated: OR = 7.062, p = 0.003), mother's involvement in decisions regarding the child's healthcare (mother: OR 4.353, p < 0.001; both father and mother: OR 3.195, p < 0.001) and parents' trust in the vaccine's safety (OR = 2.483, p = 0.022). Conclusions: This study underscored the low intention among parents to vaccinate their children against COVID-19. Vaccination intention was found to be associated with education, parents' vaccination status, the mother's involvement in healthcare decisions, and parents' trust in the vaccine's safety. On the other hand, parents' concerns over the safety and efficacy of the COVID-19 vaccine were widely reported as barriers to childhood vaccination. The health authorities should focus on addressing parental concerns about vaccines to improve their COVID-19 vaccination coverage