Parenting, Social Networks and Stress: Predicting Vaccination Decisions in the COVID-19 Pandemic

Background: COVID-19 vaccination is associated with less risk of contracting COVID-19, less severe illness, and lower transmission rates (Tregoning et. al, 2020). Despite these public health benefits, COVID-19 vaccination has become a highly politicized issue, and vaccination rates vary (Bolson & Palm, 2022). We use a longitudinal study of parents to examine how social networks, internet usage, health, and pandemic parenting practices predict beliefs about vaccinations and decisions to vaccinate.

Methods: We used data from Waves 1 and 3 of the Central Ohio Family Study, which included parents of children aged between age 2 and 12 (n=238). Parents were sampled via Craigslist or Facebook ads and participated in online and app-based Ecological Momentary Analysis (EMA) surveys.. Data for this study was extracted from the baseline Wave 1 survey at the beginning of the pandemic (April-May 2020) and a follow-up survey at Wave 3 when COVID-19 vaccinations were available for populations aged 5 and older (February-March 2022). We assessed toxic social networks (e.g. “There are people in your life who often criticize you or put you down”), self-rated health, positive and negative experiences on the internet related to parenting (e.g. frequency of feeling shamed about parenting online) and parenting behaviors during the pandemic using the Parenting in a Pandemic Scale, which examines teaching children about disease transmission, maintaining structure, and responding to socio-emotional needs of child (PIPS; Waller et al., 2020). Longitudinal multivariate modeling was used to analyze data; we controlled for demographic characteristics of the parent and child.

Results: Having higher toxic social network scores at Wave 1 was associated with less supportive views of vaccines at Wave 3. Higher income and higher PIPS scores were associated with more supportive views of vaccines. Higher toxic social network scores at Wave 1 were associated with lower odds of the parent being vaccinated for COVID-19 at Wave 3. Parental age and higher PIPS scores were associated with higher odds of the child being vaccinated for COVID-19 at Wave 3. Self-rated health and internet usage related to parenting were not significantly related to outcomes; bivariate analyses revealed a strong association between watching YouTube videos and not receiving the COVID-19 vaccine.

Discussion: Conflict amongst family and friends at the very beginning of the pandemic predicted vaccine beliefs and a parent receiving the vaccine approximately two years later. Parents with conflictual relationships may have less trust in others, which could extend to public health measures. Parents who increased structure, information about disease transmission, and attention to children’s socio-emotional needs as a result of the pandemic were more likely to view vaccines positively and get their child vaccinated. Although the role of the internet has been postulated as a source of disinformation regarding vaccines, we did not find associations between Wave 1 internet experiences and Wave 3 vaccine decisions. It could be that parents changed or increased their internet research and usage during the pandemic. Our results suggest that parents who have difficult interpersonal relationships may be in need of targeted interventions for public health messaging.