It's Time for a National Surveillance System for Vaccine Confidence and Hesitancy

How did the coronavirus disease 2019 (COVID-19) pandemic change parents’ confidence in and motivation to get vaccines for their children? Two studies in this issue of Pediatrics seek to address this pressing question, providing novel data that suggest reasons for both reassurance and concern. Beginning with the good news, Higgins et al found no change in a composite measure of vaccine beliefs (or confidence) and motivation (hesitancy) when they surveyed repeated cross-sections of Colorado parents about early childhood vaccination over the course of the pandemic. The bad news was that the study identified large proportions of parents (19% to 23%) with serious misgivings about vaccines at each time point, with the proportion being even higher among some parents of minoritized children, parents with lower levels of education, and others. In contrast, Honcoop et al used qualitative data from a multistate sample of 36 parents to understand hesitancy to get COVID-19 vaccines for children. They found trust in health care providers on the one hand, but a desire for more information and high exposure to misinformation on the other. Taken together, these studies suggest that the pandemic failed to fundamentally reshape parents’ orientation to childhood vaccination, but that low confidence and high hesitancy nevertheless remain prevalent and persistent barriers to protecting our children from vaccine preventable diseases.