Coronavirus (COVID-19) and flu vaccination programme: user journeys and experiences

5. Views on children getting vaccinated against Covid-19 and the flu

Key points

• Parents typically felt they and their children were in agreement on getting a Covid-19 vaccine. Older children tended to be more involved in decision making compared to younger children.
• Those with strong views on the Covid-19 vaccination typically felt similarly regarding whether their children should become vaccinated. Those who had not had any Covid-19 vaccinations themselves were particularly against having their children receive it.
• Where there was divergence in views, it was among participants who had engaged in the Covid-19 vaccination programme themselves but were not confident in their children receiving a Covid-19 vaccination.
• There were two key reasons for this: (1) a perception that children did not need the vaccine due to being low risk and (2) believing that they had taken a risk by getting a newly developed vaccine and feeling uncomfortable with taking this decision on behalf of their children.
• Risks that were more of a worry for children included impacts on puberty and fertility, which participants were less concerned about for themselves personally.
• Parents tended to be more comfortable with children receiving a flu vaccine than a Covid-19 vaccine (in line with overall trust in the flu vaccine described in the previous chapter).

This chapter looks at parents' views on their children receiving vaccinations against Covid-19 and flu.

Views on children receiving a Covid-19 vaccination

Parents typically reported that they and their children had been in agreement about them getting a Covid-19 vaccine. Older children were generally more involved in the decision making than younger children.

"Aye, I never pressurised him – he knew everything himself. When we got the appointment letter in, I asked him if he wanted to go, and he said yes."

Participant with 17-year-old son, white Scottish, woman, 40+, 3+ Covid-19 vaccinations

For those in two-parent households, the decision was generally made by both parents.

Those who felt most strongly about the Covid-19 vaccination, either positively or negatively, typically held similar views when it came to their children. Those who had not had any Covid-19 vaccinations themselves were particularly opposed to having their children receive it.

Where there was divergence, it was among participants who had engaged in the Covid-19 vaccination programme themselves but were not confident in their children receiving a Covid-19 vaccination.

"It's different putting stuff in my own body but I'm not willing to risk putting stuff into my kids… I was just reading more into the kids' ones and there were more cons than pros, I thought. So, at the time I just left it"

Participant, white Scottish, woman, 40+, 2 Covid-19 vaccinations

For participants who were in favour of or open to their child being vaccinated, reasons included: protecting them and people around them from Covid-19, making it easier to travel, to avoid them missing school due to Covid-19, and because their friends were getting vaccinated without any problems.

"Yes, I'm fully decided on [my son] especially, I think just for the holidays as well it saves you having to do tests and stuff. Just because he is getting a bit bigger as well he is out and about, if he is not vaccinated sometimes they can restrict you as well. Just so he doesn't get no well, but he keeps pretty good anyway."

Participant, Mixed/Multiple Ethnic Group, woman, under 40, 3+ Covid-19 vaccinations

Participants who were against their children receiving a Covid-19 vaccination gave two main reasons for this: first, a perception that children did not need the vaccine due to being low risk, and second, a belief that taking the newly developed vaccine could be a risk, and feeling uncomfortable with taking this decision on behalf of their children. These two reasons were interconnected for some parents: they were uncomfortable with the possible risks of having their child(ren) vaccinated, and since they felt their child(ren) were fairly well protected from Covid-19 even without the vaccination, it did not feel worth that risk.

The first reason, a feeling that their child(ren) were not at real risk of Covid-19 and therefore did not need to be vaccinated, was informed in some cases by participants' direct experiences of their children having contracted the virus but having very minor or no symptoms and recovering quickly.

Where parents were concerned about the possible unknown risks of vaccination and felt uncomfortable with making that choice for their children, one risk that was felt to be more worrisome for children was the possible impacts of the vaccine on puberty and fertility.

"I think the main one is she has not really gone through puberty or anything yet, so she has not had her own like body changes, and when I got the vaccine it really did mess with my periods and things a lot […] So, I wasn't willing to risk that, she has not gone through her own hormones yet […] I guess as well, we don't know the long-term effects of the vaccine. I mean I've lived my life, I've got my kids, so if anything bad happens to me, it doesn't matter. Whereas I don't want to take that opportunity away from her."

Participant, white Scottish, woman, under 40, 3+ Covid-19 vaccinations

When asked what would have to change for them to be happy for their child to be vaccinated against COVID-19, the factors mentioned were: an emergence of a concerning new variant or one that affected children more seriously; it becoming mandatory for children to get the vaccine; or having more information on possible long-term impacts for children.

There were also parents who said that they could not currently imagine any scenario in which they would be comfortable with their children receiving the COVID-19 vaccine.

"I dinnae think anything would really make me happy, I still dinnae really want them to have it, but I have to kind of weigh it up."

Participant, white Scottish, woman, aged 40+, 2 Covid-19 vaccinations

Views on children receiving a flu vaccination

Parents tended to be more comfortable with children receiving a flu vaccination than a Covid-19 vaccine. This was in line with participants' views on the flu vaccine more generally, as discussed in the previous chapter.

Participants felt more comfortable with the flu vaccine for two main reasons: the flu vaccine had been around for a long time without major problems, and the flu vaccine was administered in schools by nasal spray, and therefore felt less invasive than an injection. There was also a perception that the flu vaccine is 'normal' and established – it was generally not felt to be a particularly big or important decision.

"Now he's getting flu vaccine in the form of the nasal spray, it's kind of easy for him to get."

Participant, White Polish, woman, 40+, 3+ Covid-19 vaccinations

For participants who chose to not have their children vaccinated against the flu, this was typically because they felt that it was not medically necessary.

"If he is not sick or at risk of being really, really, sick from […] the flu during the winter months, then why keep adding chemicals into his body when I don't really know what it is doing? […] But for the Covid, it was different, because lots of people were dying"

Participant, Black African, woman, 40+, 3+ Covid-19 vaccinations

There were also participants who reported that their child or children had experienced more flu symptoms during the winters where they had been vaccinated, and therefore felt that it was preferable for them not to receive the vaccination.

Participant story: Amy

Amy works for the NHS and was on maternity leave at the time of interview. She has an 11-year-old child, and a young baby.

She did a lot of research before deciding to accept the first Covid-19 vaccination, because she felt very uncertain about whether it was the right decision. Her main concern was around the possible impact on her baby, as she was still breastfeeding at the time.

"I still didn't know, even when sat down in the chair at the vaccination centre, that I was going to go ahead or not."

She actively sought out a lot of information, looking at sources like World Health Organisation (WHO) documents, independent journal articles, and official NHS and government websites. Another big influence for her was the nurse who was administering the vaccine – she was able to talk Amy through the data and outlined how the advantages outweighed the downsides. It also helped that the WHO had produced data just a few days before saying that it safe to be vaccinated while you were breastfeeding. Once she made the decision, her experiences of the next two vaccine doses were very straightforward, as illustrated in the user journey diagram below.

However, she still feels strongly opposed to having her children vaccinated against Covid-19. She does not think there has been enough research done on the possible long-term impacts on children, including the impact on fertility and children who have not gone through puberty yet. Amy thinks that maybe once her children are older, and are more able to make their own decisions, she would feel more confident.

User journey: Amy

This is the user journey of Amy, a woman with an 11-year-old and new-born baby.

• Influences on her decision to get the vaccination – Discussed with vaccinating nurse and the benefits (additional protection and a bit of normality back) seemed to outweigh the risks (including possible impacts on breast milk).
• Motivations to get 1^st vaccination – Health risks to others (including her kids).
• 1^st vaccination experience – Anxiety on the day. Vaccinated at leisure centre. Fairly busy but well organised. Side-effects were exhaustion and sore head – also the exhaustion of making a big decision.
• Motivations to get 2^nd vaccination – Much easier decision because first one had been fine.
• 2^nd vaccination experience – Invited by letter again. Went with partner this time. Brought baby in pram, staff all fine, a lot busier but OK.
• Motivations to get 3^rd vaccination – Protecting herself and others so she could see family in the new year.
• 3^rd vaccination experience – Set up appointment over Christmas. Took both kids, all very straightforward.
• Motivations to get flu vaccination – Routine practice – gets it every year.
• Flu vaccination experience – In her own words: "I guess it is just normal to get it." Gets it every year. Vaccinated at GP – straightforward and positive. Didn't want to get it with Covid-19 booster as worried she would get sick.