OBJECTIVES Addressing parental/caregivers' coronavirus disease 2019 (COVID-19) vaccine hesitancy is critical to improving vaccine uptake in children. Common concerns have been previously reported through online surveys, but qualitative data from KII and focus groups may add much-needed context. Our objective was to examine factors impacting pediatric COVID-19 vaccine decision-making in Black, Spanish-speaking, and rural white parents/caregivers to inform the content design of a mobile application to improve pediatric COVID-19 vaccine uptake. METHODS Parents/caregivers of children aged 2 to 17 years from groups disproportionately affected by COVID-19-related vaccine hesitancy (rural-dwelling persons of any race/ethnicity, urban Black persons, and Spanish-speaking persons) were included on the basis of their self-reported vaccine hesitancy and stratified by race/ethnicity. Those expressing vaccine acceptance or refusal participated in KII, and those expressing hesitancy in focus groups. Deidentified transcripts underwent discourse analysis and thematic analysis, both individually and as a collection. Themes were revised until coders reached consensus. RESULTS Overall, 36 participants completed the study: 4 vaccine acceptors and 4 refusers via KIIs, and the remaining 28 participated in focus groups. Participants from all focus groups expressed that they would listen to their doctor for information about COVID-19 vaccines. Infertility was a common concern, along with general concerns about vaccines. Vaccine decision-making was informed by the amount of information available to parents/caregivers, including scientific research; possible positive and negative long-term effects; and potential impacts of vaccination on preexisting medical conditions. CONCLUSIONS Parents/caregivers report numerous addressable vaccine concerns. Our results will inform specific, targeted interventions for improving COVID-19 vaccine confidence.

中文翻译：

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家长对 COVID-19 疫苗的犹豫：一项定性研究。

目标 解决父母/看护者对 2019 年冠状病毒病 (COVID-19) 疫苗的犹豫对于提高儿童疫苗接种率至关重要。之前已经通过在线调查报告了常见的担忧，但来自 KII 和焦点小组的定性数据可能会增加急需的背景信息。我们的目标是研究影响黑人、西班牙语和农村白人父母/看护者儿科 COVID-19 疫苗决策的因素，为移动应用程序的内容设计提供信息，以提高儿科 COVID-19 疫苗的接种率。方法 将 2 至 17 岁儿童的父母/照顾者纳入其中，这些儿童来自对 COVID-19 相关疫苗犹豫不决的群体（任何种族/族裔的农村居民、城市黑人和讲西班牙语的人）他们自我报告的疫苗犹豫情况并按种族/民族进行分层。那些表示接受或拒绝疫苗的人参加了 KII，而那些表示犹豫的人参加了焦点小组。去识别化的记录进行了话语分析和主题分析，无论是单独的还是作为一个集合。主题不断修改，直到编码人员达成共识。结果 总体而言，36 名参与者完成了研究：4 名疫苗接受者和 4 名通过 KII 拒绝疫苗接种者，其余 28 名参与者参加了焦点小组。所有焦点小组的参与者均表示，他们会听取医生的意见，了解有关 COVID-19 疫苗的信息。不孕不育是一个普遍的问题，还有对疫苗的普遍担忧。疫苗决策取决于父母/照顾者可获得的信息量，包括科学研究；可能的积极和消极的长期影响；以及疫苗接种对原有疾病的潜在影响。结论 家长/看护者报告了许多可解决的疫苗问题。我们的结果将为提高 COVID-19 疫苗信心的具体、有针对性的干预措施提供信息。