| Newness of SARS-CoV-2 vaccines and supporting evidence |
Uncertainty about vaccine risks and adverse effects, given their newness New mRNA technology and limited understanding thereof Lack of clear evidence of benefit or need of SARS-CoV-2 vaccine for children Perception that SARS-CoV-2 vaccine is different, and therefore less trustworthy, than other (routine) childhood vaccines Perception that risk of vaccine outweighs risk of COVID-19 (based on either sparse evidence regarding long-term adverse effects or individual stories of adverse effects) Reduced opportunities for in-person discussions with health care providers because of the shift to virtual care
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Trust in evidence supporting vaccines, despite their newness Perception that risk of COVID-19 outweighs potential risk of vaccine (based on appraisal of evidence or experience witnessing individuals contracting SARS-CoV-2) Consultation with trusted sources (e.g., health care providers, colleagues)
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| Politicization of SARS-CoV-2 guidance |
Perception that guidance for SARS-CoV-2 vaccination is politically or financially motivated Distrust of politicians who may have biases or agendas Distrust of media who are seen as having taken sides or fear mongering Dissatisfaction with government involvement in health care decisions, including public health measures for COVID-19 (e.g., masking and social distancing requirements).
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Widespread messaging (from politicians, news sources, social media, etc.) keeping vaccination top of mind
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| Social pressure surrounding SARS-CoV-2 vaccinations |
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Pressure from family members to get vaccinated Fear of stigma or exclusion if unvaccinated (e.g., kids being excluded from sports teams, being ostracized at school)
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| The weighing of individual v. collective benefit |
Unease about putting foreign substances into children who are still developing (most concerning for younger children) Concern about potential vaccine adverse effects because of perceived parental responsibility or child’s specific medical condition Lack of perceived need for their own child because of previous infection, adherence to measures such as masking or perceived health of child Lack of convincing evidence of the public health benefits of vaccinations for children Perception that children should not be responsible for the health of others
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Individual protection against SARS-CoV-2 Public health benefits (e.g., reducing spread, herd immunity, protecting others) Desire for return to normalcy (e.g., kids socializing again, no longer wearing masks, returning to in-person classrooms) Allowing children to make choice for themselves
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