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Mothers are particularly hesitant about getting the COVID-19 vaccine for themselves and their children, according to the latest data.

For instance, one in three younger mothers say they are "extremely unlikely" to vaccinate their children, according to the, a nationwide survey that also found higher rates of "vaccine resistance" among mothers.

Another found that while nearly two-thirds of all adults have either already been vaccinated against COVID-19 or plan to do so, mothers rank highest among those unwilling to get vaccinated or uncertain about getting their shot, at 51% -- roughly 20 percentage points higher than other women at 32%, fathers at 29%, and other men at 28%.

In general, parents' attitudes toward vaccinating their children mirrored their , noted Matthew Simonson, a PhD candidate at Northeastern University in Boston and lead author of the COVID States Project report.

Simonson told MedPage Today that "on average, mothers were no more or less willing to vaccinate their children than they were to vaccinate themselves."

Dads and Young Moms

The researchers also highlighted a "major gap" between mothers' and fathers' attitudes toward vaccinating themselves and their children, and that gap appears to be growing.

In the COVID States Project, fathers' resistance to vaccination fell slightly, from 14% to 11% between February and April, while mothers' resistance remained fixed, with around 27% saying they are "extremely unlikely" to vaccinate their children.

Simonson stated that the age of the mother "plays a big role" in attitudes toward vaccination, with 31% of younger mothers (age 35 and below) saying they were "extremely unlikely" to vaccinate their children, whereas 25% of older mothers were vaccine resistant.

That "roughly one in three younger mothers says, 'No way. I'm not going to get my child vaccinated,'" was very troubling, said Simonson.

His group zeroed in on those who were "extremely unlikely" to vaccinate their children, so the number on the fence about vaccination is likely even higher.

'Will It Work for Me and My Family?'

The mothers (hesitant or resistant) surveyed expressed concerns about whether the vaccines had been adequately studied and appropriately evaluated for general use, Simonson said.

However, "we don't find large numbers of our survey respondents hawking conspiracy theories, or making themselves out to be ideological 'anti-vaxxers,' he explained. "It really seems to come from a place of concern about what the science really says, and if they can trust something that's new and, to them, unknown."

During listening sessions last fall hosted by the Reagan-Udall Foundation for the FDA, the most common concerns were: "'How did you get there [to emergency use authorization] so fast?'" and "'Will it work for me and my family?'" said Susan Winckler, RPh, CEO of the foundation, an independent nonprofit established by Congress to support FDA's mission of accelerating innovation and increasing product safety.

"'Me and my family' is really important," for moms in particular, said Winckler.

Simonson speculated that gender roles and societal pressure may contribute to maternal vaccine hesitancy.

"I think there's a lot of pressure on women -- from society, from other men, from other women -- to not screw up when it comes to their children's health," he said, citing the sheer volume of studies, articles, and online discussion forums on mothers and breastfeeding as an example.

"I think that there are a lot of mothers out there who believe that they're playing it safe by not vaccinating their children, when in fact the opposite is true. Playing it safe would mean keeping your children safe in the pandemic," Simonson said.

Winckler said that the foundation stressed during the listening sessions that "no steps were skipped." Scientists and drug developers "did a lot of things that would have been done consecutively [during vaccine development] concurrently," she said.

"The other concern we heard was not wanting to be first," Winckler said.

"We're way past first," she added. "We're now in the second half of the adult population of the United States."

Behavioral scientist Alison Buttenheim, PhD, MBA, associate professor of nursing and healthy policy at the University of Pennsylvania School of Nursing in Philadelphia, said hesitancy among mothers could center on that the vaccine might affect their fertility, or their daughters' fertility.

Also, younger mothers tend to do more research about health and healthcare, and could potentially be more exposed to "anti-vaccine or vaccine-concerned content."

Mothers may also be more inclined to turn to their social networks for information, Buttenheim said, noting that those conversations "may be very efficient spreaders of good information or bad information."

Addressing Hesitancy

Winckler and Buttenheim pointed out that strategies around COVID-19 vaccination promotion need to shift gears.

Access could still be improved for those who aren't prioritizing getting their shot, Winckler stated, with a strategy that moves from "access" to "accessibility," such as setting up vaccination sites at county fairs.

"Not a lot of people at this point need to see a [vaccine promotion] sign on a bus," said Buttenheim. What's needed is to pivot from mass vaccination sites to a hyper-local approach, like healthcare partnering with ice-cream trucks that make the rounds in neighborhoods. "You should be able to flag one down."

Buttenheim added that she's frustrated by the "bureaucracy" of the CDC, which thus far has failed to make COVID vaccination part of primary care physicians' regular visits. "It should not be 2022 before it's common to get the COVID vaccine at your primary care doc," she said.

Winckler said personal connections and word-of-mouth can also help. Her son got his vaccine the morning after he turned 16, and he'll be getting his second dose soon. Other mothers in her social circle say, "'Let me know how that goes, because I'm thinking about it for my kids.'"

Moms are powerful communicators, Winckler emphasized, "so we've got to arm them with the information to make the choice, and then if they're making the choice to get vaccinated, they become influencers."

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