A new study has found that parents make markedly different decisions when it comes to vaccinating their children against seasonal influenza (SIV) versus COVID-19, suggesting that each type of vaccine elicits distinct psychological responses and decision-making processes.
The study, led by Yuan et al., used a mixed-methods approach combining in-depth interviews and longitudinal surveys to understand how parents weigh factors such as trust, routine, media influence, and emotion when making vaccination decisions. The results highlight a crucial divide. while influenza vaccine decisions are often driven by past behaviors and perceived norms, decisions about COVID-19 vaccines tend to involve more anxiety, scrutiny, and uncertainty.
The study consisted of two parts: Study 1 was a qualitative investigation involving 29 parents to explore and compare their decision-making processes for children’s SIV and COVID-19 vaccinations. In Study 1 the parents found that many used the influenza vaccine as a benchmark to judge the newer COVID-19 vaccine. While decisions about the flu shot were often automatic and based on past behaviour or routine, parents showed far more hesitation and deliberation around COVID-19. Factors like negative news coverage, personal anecdotes, and emotional distress were found to heavily influence their thinking.
The second part of the study tracked over 632 parents over time and used machine learning to determine which psychological factors most influenced vaccination decisions. It confirmed that emotional and situational factors, such as anxiety and media exposure, significantly affected decisions about the COVID-19 vaccine. In contrast, a history of past flu vaccinations was the strongest predictor for SIV uptake.
Yuan et al. found that parents adopt different strategies when deciding on each vaccine, highlighting that targeting key influencing factors could enhance the effectiveness of future vaccination campaigns. The researchers also noted that parents’ initial intentions reliably predicted whether their children would receive the flu vaccine, but not the COVID-19 vaccine indicating greater uncertainty and variability in decisions related to newer vaccines.
A similar study by Goldman et al. found that parents are more likely to accept vaccines that are familiar and have a long-standing safety record, like the influenza vaccine. In contrast, novel vaccines such as COVID-19 tend to elicit more scrutiny and hesitation. Another study by Freeman et al. showed that parental anxiety, exposure to negative news, and anecdotal reports about side effects significantly influenced hesitancy toward COVID-19 vaccines.
In an era marked by expanding vaccine options and widespread information—both reliable and misleading—it is crucial to understand the specific psychological and emotional factors that shape parental decisions. For newer vaccines like COVID-19, public health campaigns should prioritize clear, transparent communication and emphasize the growing body of safety and efficacy data to address hesitancy. In contrast, for more familiar vaccines such as the seasonal influenza vaccine, reinforcing routine vaccination behaviours and ensuring convenient access can help maintain or improve uptake. This underscores the need for tailored public health messaging that responds directly to the concerns, emotional responses, and contextual influences associated with each vaccine. Targeted, empathetic communication is key to building parental trust and increasing the uptake of childhood vaccinations.
References
- Yuan J, Dong M, Ip DKM, So HC, Liao Q. Dual decision-making routes for COVID-19 and influenza vaccines uptake in parents: A mixed-methods study. Br J Health Psychol. 2025 May;30(2):e12789.
- Goldman RD, Yan TD, Seiler M, Parra Cotanda C, Brown JC, Klein EJ, et al. Caregiver willingness to vaccinate their children against COVID-19: Cross sectional survey. Vaccine. 2020 Nov 10;38(48):7668–73.
- Freeman D, Loe BS, Chadwick A, Vaccari C, Waite F, Rosebrock L, et al. COVID-19 vaccine hesitancy in the UK: the Oxford coronavirus explanations, attitudes, and narratives survey (Oceans) II. Psychol Med. 2022 Oct;52(14):3127–41.