Differences between Canadian parents’ attitudes toward routine, influenza, and COVID-19 vaccines for their children, and changes in vaccine hesitancy since the pandemic: A national cross-sectional comparative study

BACKGROUND: Evidence suggests the COVID-19 pandemic had heterogeneous and vaccine-specific effects on parental attitudes toward childhood vaccination. A decline in vaccine confidence has been noted in some settings, however even studies reporting stable or increased confidence suggest polarized attitudes with stronger pro- and anti-vaccine views emerging concurrently. We explored differences between Canadian parents' attitudes toward childhood routine, influenza, and COVID-19 vaccination, and changes in attitudes since the pandemic. METHODS: In 2025 we conducted a cross-sectional national online survey of parents with children aged 0-17 years using a polling firm. Previously validated questions asked about parents' attitudes toward vaccination using the '5C' scale, capturing separate responses for routine, influenza, and COVID-19 vaccines. We assessed changes in attitudes about routine vaccination over time by comparing 5C responses from two previous surveys conducted in 2020 and 2021. We calculated proportions and 95% confidence intervals (CIs). RESULTS: Respondents (N = 1327) were proportionally representative across provinces, but not the territories. Parents were most confident in the safety of routine vaccines (71.0%, 95%CI 66.5-75.7), compared to influenza (63.7%, 95%CI 59.5-68.1) and COVID-19 (57.9%, 95%CI 53.9-62.1). The majority indicated the pandemic did not change attitudes about routine (60.8%) or influenza (63.7%) vaccination, while more than one-quarter (31.6% and 27.8%) reported that routine and influenza vaccines were more important following the pandemic. In 2025, a slightly higher proportion of parents reported low confidence in the safety and effectiveness of routine vaccines (12.7% and 9.2%, respectively), compared to 2021 (8.5% and 5.6%), and 2020 (12.2% and 6.8%). CONCLUSIONS: Parental attitudes toward childhood COVID-19 vaccination differed from attitudes toward routine and influenza. Most parents reported positive or neutral impact of the pandemic on perceived importance of routine and influenza vaccines. Parents reported the highest positive attitudes toward routine vaccination mid-pandemic (2021), and parents' attitudes in 2025 were slightly less positive than in 2020 and 2021.