There are typically lower COVID-19 vaccination rates among developing versus higher-income countries, which is exacerbated by greater vaccine hesitancy. However, despite the increasing evidence of safety, parents are still reluctant to vaccinate their children against COVID-19. This is a concern in countries experiencing successive waves, such as Pakistan. Consequently, the objective of this study was to gain better understanding and practice regarding parents vaccinating their children against COVID-19 in Pakistan. A cross-sectional study was conducted to measure parents' attitudes towards vaccinating their children. In total, 451 parents participated in the study, giving a response rate of 70.4%; 67.4% were female, 43.2% belonged to the 40-49 years age group, and 47.7% had three children, with 73% of parents fully immunized against COVID-19. We found that 84.7% of parents did not consider COVID-19 to be a very serious issue, and 53.9% considered that their children were not at high risk of COVID-19. Overall, only a quarter of the study participants had currently vaccinated their children and 11.8% were willing to vaccinate their children in the near future. Parents who had a better knowledge of COVID-19, secondary or higher education, children who had chronic illness, and those parents whose children had been infected with COVID-19 were more likely to have their children vaccinated. The most common reasons for vaccine hesitancy were "my child is not at high risk of COVID-19" (61%) and "I am afraid to put/inject a foreign object inside my child's body" (52.2%). Overall, vaccine acceptance was low among the parents of the children. Those parents with higher education, chronic illnesses, greater knowledge of COVID-19 and its vaccines, and those whose children had been infected with COVID-19 were significantly (p < 0.001) inclined towards vaccinating their children. Effective campaigns as well as awareness sessions are needed to address misinformation and reduce vaccine hesitancy.
Keywords: COVID-19; Pakistan; acceptance; children; parents; vaccine hesitancy; vaccines.