Willingness and understanding of the safety and effectiveness of COVID-19 vaccines in young children: a cross-sectional study among parents in Malaysia

Background: The safety and efficacy of COVID-19 vaccinations are crucial factors that parents consider when deciding whether to vaccinate their children. Aim: This study aimed to investigate parents' understanding of COVID-19 vaccines and its association with the degree of willingness to vaccinate their young children. Method: A cross-sectional survey was conducted among the public with children younger than 12 years old. Information on parents' demography, understanding of COVID-19 vaccines and their willingness to get their children vaccinated were collected. The association between the level of understanding and willingness was tested using the One-way analysis of variance (ANOVA) test. Predictors of good understanding and high willingness were investigated using multiple linear regression. Ethics approval was granted by the Research Ethics Committee of Universiti Teknologi MARA (Reference no: REC [PH]/012/2022) and the study conforms with the Declaration of Helsinki. Informed consent was obtained from all participants. A web-based survey link was distributed through social media platforms. The initial section of the survey included a project information sheet including the purpose of the study, length of questionnaire, identity of researchers and measures taken to ensure data confidentiality and anonymity of participants. Participants provided their consent electronically prior to being granted access to the questionnaire. Results: Of the 386 respondents, 53.4% had a good understanding, and 74.6% had a high willingness. Only 42.5% agreed that the vaccines are effective in protecting children from getting COVID-19, 79.5% and 73.3% misunderstood the severity and tendency to experience the side effects, respectively. A better understanding was associated with a higher willingness to vaccinate ([F(4381) = 54.417, p = 0.000). A higher understanding was significantly associated with higher educational status (postgraduate [beta = 0.297, p = 0.028] and bachelor [beta = 0.275, p = 0.034], work in a health-related field [beta = 0.300, p < 0.001]) and have received a COVID-19 booster (beta = 0.347, p < 0.001). A high willingness was prevalent among parents working in a health-related field, had received a COVID-19 booster and had medical condition. Low willingness was observed among parents aged above 30 years old and those who have used herbal medicines. Conclusion: It is of utmost importance to comprehend parents' understanding of this topic to minimise hesitancy toward COVID-19 vaccination in children.