Comparative analysis of parental hesitancy toward influenza vaccination for children versus themselves in post-pandemic China: A cross-sectional study

This study aimed to identify factors influencing parental willingness for influenza vaccination and compare differences between their choices for themselves versus their children, in order to provide evidence-based strategies to promote influenza vaccine uptake. With an anonymous online questionnaire, this cross-sectional study investigated parents of children (aged 6 months-17 y) in Zhejiang, China (May - September 2024). A McNemar test, chi-square tests, and multivariable logistic regression models were used to assess paired differences and identify factors associated with parental influenza vaccination willingness for children versus themselves. Among 2492 parents, 84.2% were willing to vaccinate their children and 72.7% themselves, with significantly higher willingness for children (McNemar test, <i>P</i> < .001). Multivariable analysis demonstrated similar influencing patterns on vaccine willingness for both groups. However, perceived vaccine effectiveness (OR = 3.37, 95% CI: 1.42-7.98) was associated with willingness to vaccinate children, while perceived influenza susceptibility (OR = 1.47, 95% CI: 1.05-2.06) was associated with willingness for themselves. Lack of vaccine confidence was a key contributor to vaccine hesitancy for both children and parents themselves, whereas complacency was more prominent in hesitancy toward self-vaccination. Additionally, government or Centers for Disease Control and Prevention online platforms (28.5%) and healthcare workers (20.3%) were parents' most preferred sources of vaccine information. Parental influenza vaccination willingness was generally high, with greater willingness for children than for themselves. Official platforms or healthcare professionals have the responsibility to proactively disseminate correct information to the public on vaccine importance and disease awareness, so as to promote actual vaccination behavior.