Abstract
This study investigated how parental attitudes toward COVID-19 vaccination influenced the mental health and lifestyle of children and adolescents aged 7-19 years in South Tyrol, Italy, using cross-sectional data from 2022 to 2023, with 6,842 and 4,525 participants, respectively. Unadjusted odds ratios identified associations between vaccination rates and lifestyle parameters, whereas the validated questionnaires assessed mental health problems and health-related quality of life. Vaccination rates among adolescents peaked at age 12 and stabilized after 2022, when the Green Pass requirement was removed. Families with consistent vaccination status reported lower burdens in 2022 and better lifestyles in 2023, whereas unvaccinated families experienced higher burdens and lower quality of life in 2022 but not in 2023. Proxy reports indicated fewer mental health issues in vaccinated families, while self-reports revealed more psychosocial problems in unvaccinated families, particularly in 2022. By 2023, parents who did not respond to the vaccination question faced the greatest burden, and children's mental health (SDQ) and psychosomatic problems remained significantly higher compared to unvaccinated and vaccinated children. The results indicate that parental vaccine reluctance exerted a detrimental influence on children's pandemic experience and way of life, particularly in cases where parents did not participate in vaccination programs. The impact of this non-response extends to long-lasting challenges and psychosocial issues faced by the affected children, underscoring the critical need for tailored public health measures aimed at bolstering confidence in adults' decision-making processes for vaccination and motivating reluctant communities to embrace vaccination.