Comparison of parent-reported motivators of non-vaccination for children 5-11 years old in Australia and Canada: Results of the iCARE study.

Background: Despite COVID-19 infection being less severe in children compared to adults, vaccination for children from the age of 6 months onwards is recommended in many countries to reduce symptom severity and prevent severe disease. However, vaccination against COVID-19 for children remains controversial and uptake has been low.
Aims: To assess and compare the rate of change of parent-reported COVID-19 vaccine uptake in children aged 5 to 11 years and motivators of vaccine acceptance and non-vaccination among parents/guardians in Canada and Australia.
Methods: As part of the iCARE study, two cross-sectional representative samples in Canada and Australia were collected between May 20 and September 12, 2022 (i.e., 5 and 9 months after the COVID-19 vaccine rollout for children 5-11 years) using online panels. Parents/guardians reported the vaccine status of their children and motivators for vaccine acceptance and non-vaccination. General linear models were used to estimate differences between countries in terms of vaccine uptake and motivators across time.
Results: Parent-reported vaccine uptake for children 5-11 years didn't increase over the study period (T ₁  = 87 %,T ₂  = 86 %; OR = 0.83; 95 %CI = 0.45-1.54) and was overall lower in Canada (60.8 %) compared to Australia (71.6 %)(OR = 0.56; 95 %CI = 0.33-0.96). In both countries the socioeconomic characteristics of parents who didn't vaccinate their children were similar and having information on either the short- or long-term side effects of the vaccine were important motivators. However, vaccine effectiveness was more important in Canada and trust in the company that developed the vaccine and a recommendation from the child's doctor were more important motivators in Australia.
Conclusion: Parent-reported vaccine uptake for children 5-11 years plateaued early in the vaccine rollout. The main motivators for parents of unvaccinated children varied between the two countries but information on vaccine safety and effectiveness were common to both countries. Findings may inform future tailored vaccine communication efforts and pandemic planning in Australia and Canada to optimize vaccine uptake for primary school children.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [Kim L Lavoie reports financial support was provided by Canadian Institutes of Health Research. Kim L Lavoie reports financial support was provided by Canadian Institutes of Health Research. Simon L. Bacon reports financial support was provided by Canadian Institutes of Health Research. Simon L Bacon reports financial support was provided by Canadian Institutes of Health Research. Kim L Lavoie reports financial support was provided by Canada Research Chairs Program. Kim L Lavoie reports financial support was provided by Quebec Health Research Fund. Kim L Lavoie reports financial support was provided by Quebec Research Fund Society and Culture. Simon L Bacon reports financial support was provided by Quebec Ministry of the Economy and Innovation. Frederique Deslauriers reports financial support was provided by Mitacs Canada. Frederique Deslauriers reports financial support was provided by Canadian Institutes of Health Research. Frederique Deslauriers reports financial support was provided by Canadian Institutes of Health Research. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper].
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