Pain Cognitions as Predictors of Caregiver Readiness to Vaccinate their Child Against COVID-19


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Background: Caregiver vaccine hesitancy towards the COVID-19 pandemic is multifactorial in nature and can be explored using the Health Belief Model (HBM) and its associated constructs (perceived susceptibility, severity, cues to action, benefits and barriers). However, minimal investigation has explored whether caregiver pain cognitions influence vaccine acceptance or rejection. Aims: This study aimed to measure caregiver pain cognitions, both for themselves and their children, the other constructs of the HBM, caregiver characteristics, and caregiver readiness to vaccinate their children against COVID-19. This study hypothesized that caregiver pain cognitions will contribute to observed vaccine hesitancy, above and the constructs of the HBM. Additionally, this study aimed to explore whether caregiver attitudes towards their childÕs pain mediate the relationship between their own pain attitudes and readiness to vaccinate their child against COVID-19. Finally, sociodemographic variables were examined as possible moderators of the relationship between caregiver pain attitudes and readiness to vaccinate against COVID-19. Results: Data was analyzed from 299 caregivers of children aged 6 to 11 years via an online survey. Caregivers rated perceived threat of COVID-19, cues to action, barriers and benefits of vaccination, readiness to vaccinate against COVID-19, pain-anxiety, needle fear and phobia, fear of child pain and catastrophizing about childÕs pain. The dependent outcomes were caregiver stage of change and readiness to vaccinate child against COVID-19. Hierarchical regressions were used to determine predictive ability of HBM constructs and pain attitudes on parent vaccination readiness. After controlling for parental vaccination status, HBM constructs accounted for an additional 36% of the variance in readiness to vaccinate, which is a large and significant effect (f2 = 1.5; p < .001). When added to the existing HBM model, neither caregiver attitudes towards their own pain (p = .35) nor towards their childÕs pain (p = .34) was predictive of caregiver readiness stage to vaccinate. Conclusions: The established constructs of the HBM can be used to predict caregiver readiness to vaccinate against COVID-19. However, data were collected from a non-representative sample, limiting applicability of findings. Needle fear and broader pain attitudes did not significantly contribute to parental decisions to vaccinate their children against COVID-19.