Abstract
India's National COVID Vaccination Program recommended vaccination of children ages 6-12 years in April 2022. This study assessed vaccine acceptance among mothers to better understand potential barriers and facilitators of national acceptance of pediatric coronavirus disease 2019 (COVID-19) vaccination. Qualitative data were collected through three focus group discussions (FGDs) with mothers who had children younger than 12 years of age; FGD-1 was composed of mothers who worked at a tertiary medical center in India, whereas FGD-2 and FGD-3 were composed of mothers who sought care at urban and rural community health centers. Investigators recorded, transcribed, translated, and analyzed FGDs by inductive thematic analysis. Emerging themes related to pediatric COVID-19 vaccination were categorized as knowledge and awareness, attitudes and perception, vaccine intent and facilitators, and future recommendations to promote vaccine uptake. FGD-2 and FGD-3 participants displayed limited knowledge and false beliefs regarding the pediatric COVID-19 vaccine, but mothers in FGD-1 demonstrated adequate knowledge, likely because they are health care providers. Mothers in all three FGDs expressed COVID-19 vaccine hesitancy because of concerns of side effects and low disease prevalence in children. They reported much more fear about giving the vaccine to their children than they felt about receiving it themselves. Overall, education was negatively correlated with vaccine knowledge, but mothers in all groups shared similar hesitancy about their intention to accept the vaccine for their children. Educating parents in India about the COVID-19 vaccine, especially its safety and efficacy in children, is crucial to the success of a national vaccine program.