Abstract
BACKGROUND: Coronavirus disease 2019 (COVID-19) vaccination remains an essential strategy for reducing disease burden. Specific guidelines for vaccinating children with systemic lupus erythematosus (SLE) are currently unavailable, highlighting the gap in tailored recommendations for this population. PURPOSE: This study aimed to estimate parental intention to vaccinate children with SLE against COVID-19 and identify factors associated with this intention. It also explored parents' attitudes toward the vaccine. METHODS: Seventy-four parents of patients aged 5-21 years who were diagnosed with SLE before 18 years of age were surveyed regarding their willingness to further vaccinate their children with SLE against COVID-19. The parents were categorized into vaccine acceptance (VA) and vaccine hesitancy (VH) groups and completed a validated 6-item questionnaire designed to gauge their attitudes toward the vaccine. Vaccine hesitancy scale (VHS) scores were calculated with higher scores indicating increased VH. The adjusted odds ratios (aOR) (95% confidence interval [CI]) for VA-associated factors were determined using multivariate analysis. RESULTS: Twenty-five parents (33.8%) were diagnosed with VH. Compared with the VH group, the VA group showed a higher frequency of previous COVID-19 vaccine uptake, completed immunization in children, and parental willingness to be vaccinated themselves. Children were older in the VA versus VH group. The mean total VHS score was significantly higher in the VH versus VA group. In a multivariate model of factors differing significantly between the VA and VH groups, parental willingness to vaccinate themselves (aOR, 5.0; 95% CI, 1.2-20.4), patient age (aOR, 1.4; 95% CI, 1.1-1.9), and VHS score on vaccine efficacy belief (aOR, 0.1 [0.0-0.5]) were significantly associated with VA. CONCLUSION: A significant proportion of parents were hesitant to vaccinate their children with SLE against COVID-19. These insights underscore the importance of developing targeted educational interventions to address specific parental concerns and improve vaccine uptake in children with SLE.