The vast majority of parents of at-risk children diagnosed with chronic lung disease have said advice from their GPs and paediatricians about the COVID-19 vaccine would positively impact their decision to get their kids vaccinated, a new survey has found.

The research, conducted by scientists from the University of New South Wales and published in Health Science Reports, also found that a greater percentage of parents of children with chronic lung disease were willing to get their kids vaccinated with the COVID-19 shot than the influenza shot, and that safety concerns were a key driver for parents unwilling to give their children the COVID-19 vaccine.

Paediatric respiratory epidemiologist and lead author of the study Dr Nusrat Homaira said the results showed the important roles that healthcare workers played in promoting vaccine uptake.

“Children with chronic lung disease is a unique group as they require ongoing follow-up visits with their GPs and paediatricians for their chronic conditions. GPs and paediatricians can leverage scheduled follow-up visits to promote COVID-19 vaccines and explain the benefits and rare side effects of the vaccine,” she said.

Vaccine trends in an at-risk population

Dr Homaira told Lab Down Under that the research was conducted before the Pfizer-BioNTech COVID-19 vaccine had received emergency authorisation for use in adolescents in the United States and had not yet been considered for use in Australia.

“So before the vaccine became widely available, we wanted to understand if parents of children with chronic lung conditions would be willing to get their children vaccinated against COVID-19 when it becomes available so that findings can help target public health massage to improve vaccine uptake in this group of vulnerable children,” she said.

These results come at a time when the highly contagious delta variant of COVID-19 means children are more likely to be infected. While most children globally are not vaccinated against COVID-19, countries like Australia have started inoculating those aged 12 years and over, with vaccines for children as young as five possibly being rolled out next year.

“When a COVID-19 vaccine becomes available for wider use in other paediatric populations across the world, it is likely that vulnerable children such as those with an underlying chronic lung disease may be prioritised, as they have been in adult populations,” the researchers wrote.

Children with chronic lung disease are already a priority group for vaccines against other respiratory illnesses such as influenza and pneumococcal disease which can be more severe in these children and exacerbate the underlying lung condition, Dr Homaira said.

These conditions typically include asthma, cystic fibrosis, congenital diaphragmatic hernia, tracheo-esophageal fistula, non-cystic fibrosis bronchiectasis, and primary ciliary dyskinesia.

Safety concerns bolster vaccine hesitancy

The research was conducted from November 2020 to February 2021 through an online survey completed by just over 200 parents of children with chronic lung disease treated at Sydney Children’s Hospital, one of Australia’s leading paediatric hospitals.

The survey consisted of 14 closed-ended questions looking at demographic data as well as reasons for accepting or refusing the COVID-19 vaccine.

Seventy-seven per cent of parents surveyed said they were willing for their child to get a COVID-19 vaccine. Primary reasons for vaccine acceptance were that it would prevent a parent’s child from getting COVID-19 and that their child would be at a higher risk if they came down with COVID-19 than a child without a chronic lung condition.

Only nine per cent of parents surveyed said they would not get their child vaccinated while 14 per cent were unsure. Among the top reasons for hesitancy included a belief that the vaccine could give the child an illness other than COVID-19 or that the vaccine did not work and would give the child COVID-19.

“The main concerns were around the safety of the COVID-19 vaccine and the majority of parents who were not willing to take the vaccine believed the vaccine would give their child another disease and that the vaccine might have side effects,” Dr Homaira said.

However, the research found that the “vast majority” of those willing to get their children vaccinated said that advice from their GPs and paediatricians would positively impact their decision to get their children inoculated.

GPs can leverage these results, researchers say

The results show that there is a lack of accurate information out there on the risks and benefits of the COVID-19 vaccine and reveal the key role that medical practitioners play in the immunisation of children with chronic lung disease.

“These findings clearly suggest that there is a lack of information and highlights the need for clear risk communication that will highlight the safety of the vaccine in children and also discuss what some of the rare side effects can be,” said Dr Homaira.

“When parents of children with chronic lung disease take their children to their GPs and paediatricians for scheduled follow-up visits, clinicians can play an active role in talking about the vaccine and clarifying the concerns raised by the parents.”

Dr Homaira suggested that GPs and paediatricians could leverage these findings, using their scheduled visits with children with chronic lung disease to get the child vaccinated against COVID-19.

While she acknowledged the limitations of the study, which only surveyed patients from a single hospital, she pointed out that Sydney Children’s Hospital was “one of the largest paediatric hospitals” in Australia and had a wide catchment population. The parents in the study were also representative of those with children who had common chronic lung conditions, she added.

“Also our findings were comparable to existing literature on parents attitude to other vaccines including influenza. As a next step, a survey exploring opinions of parents of children with any chronic condition across two hospitals including Sydney Children’s Hospital and Westmead Children’s Hospital may add to the existing body of evidence.”

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Featured image: A doctor and child great each other with fists. Picture by Nenad Stojkovic. Used under the Creative Commons Attribution 2.0 Generic (CC BY 2.0) licence.

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