This study explored how family communication patterns relate to parental knowledge about COVID-19, vaccine confidence, and intentions to vaccinate their children. Parents from 4 states (Ohio, New York, Georgia, and Texas; n = 702) completed an online survey in March 2021. Results revealed that conversation orientation was positively associated with both COVID-19 knowledge and overall vaccine confidence, which were both positively associated with intentions to vaccinate one's child. The relationships between the 4 subscales of conformity and the outcome variables were mixed. We discuss the potential benefits of applying family communication patterns theory to complicated situations where parents are making health decisions for both themselves and their children.