Parental Expectations, Anxiety, and Health Behaviors in Routine Childhood Vaccination: Associations with Child Pain and Symptom Experiences

Objectives In young children, somatic symptom reporting occurs through parents. Parental cognitions can directly influence the reported symptoms in their child after vaccination. Limited research exists on factors affecting parental symptom reporting. The current study examined whether parental state anxiety and side effect expectations before routine vaccinations are associated with parent reports of pain and symptoms after vaccinations. In addition, we explored health behaviors in relation to symptom expectations and observed symptoms. Study design We used data from routine vaccinations of TRAILS-NEXT cohort participants at 3, 11-12, and 45-48 months (N= 295, 300, and 167, respectively). Parents completed pre-vaccination questionnaires on anxiety and side effect expectations. They rated child pain directly after vaccination, and reported on observed symptoms in the child and parental health behaviors a week after vaccination. Associations were analyzed using multivariable linear regression. Results Higher parental anxiety before vaccination was associated with increased reported pain ratings at 3 months. Anxiety and side effect expectations were not significantly associated with the overall symptoms experienced in the week after vaccination. When exploring specific symptoms, parents tended to observe the symptoms they expected at three months but not at older ages. Parental health behaviors were primarily associated with child age and observed symptom burden rather than with parental expectations. Conclusions The findings suggest that parental anxiety affects parental pain report in young children post-vaccination, potentially shaping both symptom experience and parental symptom-related behavior. Addressing and managing parental anxiety may reduce perceived vaccination pain severity in parents of young children.