Why are so few Israeli children vaccinated? - study

A new study of more than 1,800 Israeli parents identified some of the reasons that explain the low vaccination rate among this age group.

 : Pfizer/BioNTech's new pediatric COVID-19 vaccine vials are seen in this undated handout photo. (photo credit: PFIZER/HANDOUT VIA REUTERS)
: Pfizer/BioNTech's new pediatric COVID-19 vaccine vials are seen in this undated handout photo.
(photo credit: PFIZER/HANDOUT VIA REUTERS)

According to the latest Health Ministry data, about one out of five Israeli children between the ages of five and 11 have received a COVID-19 vaccine, even though the health funds have been offering them to parents for nearly a year.

Researchers from Bar-Ilan University’s Azrieli Faculty of Medicine and its affiliated Galilee Medical Center in Nahariya identified some of the reasons for the low vaccination rate among this age group.

The new study of more than 1,800 Israeli parents was recently published in the journal Human Vaccines and Immunotherapeutics under the title “Reasons underlying the intention to vaccinate children aged 5-11 against COVID-19: A cross-sectional study of parents in Israel.” It was conducted last November – two weeks ahead of the vaccine rollout for children of that cohort.

To encourage participation from a wide range of individuals representing Israeli society, the researchers used advertisements in Arabic and Hebrew that were tailored to males and females and a social-media advertising algorithm to target parents of young children.

Among the key findings that emerged: Fewer than half (43%) of parents of children in this population said they were planning to vaccinate their children against COVID-19. Another key finding was that parents’ top priority was not to protect their children against COVID-19 (56%) but to allow them to return to school and everyday life (89%) and to assure financial resilience (78%). Parents were more concerned about the safety of vaccines (53%) than the danger COVID-19 posed to children (38%).

 Israel's President Isaac Herzog is seen receiving his fourth COVID-19 vaccine dose at Hadassah-University Medical Center in Jerusalem's Ein Kerem, on January 5, 2021. (credit: HAIM ZACH/GPO) Israel's President Isaac Herzog is seen receiving his fourth COVID-19 vaccine dose at Hadassah-University Medical Center in Jerusalem's Ein Kerem, on January 5, 2021. (credit: HAIM ZACH/GPO)

Most high-income countries now offer teenage vaccination, but vaccination of younger children is less common despite evidence of its safety and effectiveness.

“The availability of COVID-19 vaccines and licensing of these vaccinations for use in children aged five to 11 is not a guarantee that parents will inoculate their children,” the researchers wrote.

The impact of misinformation online

The COVID-19 pandemic has seen the digital spread of information, misinformation and disinformation on social-media platforms on an unprecedented scale, they wrote, adding: “Mistrust in government and international health organizations has been suggested as a potential contributor to hesitancy to follow government and international health guidelines, as fewer than 30% of individuals opted to search for their own government social media publications for vaccine information and guidance.”

“Many parents don’t want to vaccinate their children because they don’t believe COVID-19 causes severe illness,” said lead study author Dr. Amiel Dror of the Azrieli Faculty of Medicine and Galilee Medical Center.

“This data can help health authorities in shaping educational and communication campaigns for vaccines to show parents, among other things, that COVID-19 can be dangerous to anyone,” he added.

Dror collaborated with his Azrieli colleague Prof. Michael Edelstein, and Tel Aviv University medical student Niko Morozov contributed to collecting and analyzing the data.

In the survey of parents, one section included information about sociodemographic characteristics, including age, gender, area of residence, household composition, number of children, parental education, parental COVID-19 vaccination status and self-reported side effects from the vaccine (major, mild or no symptoms). It also included a question about one’s intention to vaccinate their children against COVID-19. In the second section, responders indicated why they were or were not intending to vaccinate their children against COVID-19.

“Many parents don’t want to vaccinate their children because they don’t believe COVID-19 causes severe illness."

study author Dr. Amiel Dror of BIU’s Azrieli Faculty of Medicine and the Galilee Medical Center

The survey found that parents who had not been vaccinated themselves were less likely (13%) to vaccinate their children than those who were vaccinated three times (62%), twice (48%) or once (32%). Parents who had side effects after being vaccinated were less likely (58%) to vaccinate their children than those who were vaccinated and experienced major (19%) or minor (51%) side effects.

Mothers and parents above the age of 35 were more likely to vaccinate (47%) than fathers and parents aged 35 and younger (40%).

The availability of the vaccine for use in children ages five to 11 is not a guarantee that parents will inoculate them, the authors said.

“Our findings suggest that, for COVID-19, the traditional perception of vaccination benefits such as protection against severe illness has been superseded by indirect benefits such as returning to regular societal life and education institutions, as well as assuring financial resilience for the family,” they wrote. “While this finding is not surprising considering the severe disruption to normal life caused by the COVID-19 pandemic, it is not clear whether this perception of the societal utility of vaccines will continue to impact the perception of other vaccines beyond the pandemic.”