Introduction: This study aimed to assess changes in attitudes toward routinely recommended vaccines among Hawaii parents following the COVID-19 pandemic and to identify associated factors influencing these changes. Methods: An online survey was conducted in March 2023 among parents/caregivers of children aged 0-12 years residing in Honolulu, Hawaii. Data collected including sociodemographics and household characteristics, theoretical constructs of the Health Belief Model, emergency preparedness behaviors, risk perception of diseases, and attitudes toward vaccines. Descriptive statistics were used to assess parental vaccine attitudes, logistic regressions were employed to identify factors associated with changes in attitudes regarding routinely recommended vaccines (vaccines other than the COVID-19 vaccine). Results: Participants (N=278) were mostly female (84.2%), college-educated (68.3%), food-secured (66.5%), and possessed an emergency preparedness kit (50.7%). Attitudes toward routinely recommended vaccines remained unchanged in 65.1% of participants (60.1% positive, 5% negative), while 34.8% reported changed attitudes (21.9% changed to positive; 12.9% changed to negative). Multivariable logistic regression revealed that factors that influenced changes in vaccine attitudes included race/ethnicity, having a family emergency plan, concerns about climate-related health impacts, perceived time barriers, and the belief that vaccines are part of emergency preparedness plans. Specifically, individuals identifying as Japanese or Filipino, those with an emergency plan, and those less concerned about climate change were less likely to change to negative vaccine attitudes. Conversely, perceiving vaccines as unrelated to emergency preparedness and experiencing time barriers were associated with an increased likelihood of changing to negative attitudes. Conclusion: This study highlights how attitudes toward routinely recommended vaccines shifted among parents after the COVID-19 pandemic, and identifies modifiable factors such as concerns about climate change, time barriers, and the perception that vaccines are unrelated to emergency preparedness. Insight gained from these findings can guide targeted public health interventions aimed at enhancing vaccine acceptance and readiness in advance of future potential pandemics.
Glauberman et al. (Sun,) studied this question.