A total of 252 surveys was obtained; 175 participants completed 90% or more of the survey. For incomplete surveys, most unanswered questions came from the end of the survey. All incomplete surveys were included in final data analysis. However, when the participant did not answer questions for both before and during the pandemic, the individual question was excluded. Most respondents were from outpatient clinic (80.6%), female (83.3%), between 30 and 44 years old (55.2%), Democratic (40.1%), graduated high school (48.8%), had annual income < 49 K (52.4%), and were of Hispanic ethnicity (61.9%) (Table 1), reflective of the surrounding community.
Childhood Vaccine Hesitancy
Table 2 displays VHS item numbers and corresponding questions, and Table 3 summarizes individual VHS items scores and Lack of Confidence and Risk scores before and during the COVID-19 pandemic. Relative to before the pandemic, total VHS scores during the pandemic were higher. Magnitude of change was summarized by the difference in means (“During” minus “Before”). For total VHS, the mean difference was 0.075 (95% confidence interval (0.021, 0.128), p = 0.006). For Lack of Confidence, the mean difference was 0.048 (95% confidence interval (− 0.018, 0.115), p = 0.15). For Risk, the mean difference was 0.173 (95% confidence interval (0.051, 0.295), p = 0.006). For Items 6–10, “% 4 or 5” increased during the pandemic, indicating greater vaccine hesitancy. The magnitude of change was 2.72% for statements on “Vaccines are beneficial,” (Item 6, p = 0.048), 1.68% for “I do what my healthcare provider recommends about vaccines” (Item 8, p = 0.035), 5.08% for “New vaccines carry more risks” (Item 9, p = 0.01), and 6.26% for “I am concerned about vaccine side effects” (Item 10, p = 0.043). For all other items, the difference in scores before and during the pandemic was not statistically significant (p > 0.05).
We found no statistically significant change in frequencies of routine vaccines received before the pandemic and vaccines planned during the pandemic. During the pandemic, 47.3% (86 of 182) planned to receive “All” vaccines and 6.0% (11 of 182) planned to receive “No” vaccines, which was a − 6.5% and − 12.6% decrease respectively, compared to vaccines received before the pandemic. Neither change was statistically significant (p = 0.26) (Table 4).
Importance of Influenza Vaccines
We found no statistically significant change from before to during the pandemic in how parents perceived the importance of influenza vaccines. This is reflected in our added VHS Item 2 (“The influenza vaccine is important for my child’s health”). For before and during the pandemic, the data shows no statistically significant difference in scores (p = 0.13) (Table 3). Furthermore, intent to vaccinate against influenza did not significantly change. During the pandemic, 81.5% (119 of 146) answered “Yes,” a change of 2.7%, which was not statistically significant (p = 0.37) (Table 5).
Demographic Correlates of Vaccine Hesitancy
Tables 6 and 9 display statistically significant associations of demographic variables with childhood vaccine hesitancy and COVID-19 vaccine hesitancy for Lack of Confidence and Risk, assessed during the pandemic. For childhood vaccine hesitancy, household income > 100 K (p = 0.031), Hispanic ethnicity (p = 0.038), and Other/Multiple race (p = 0.039) were associated with increased confidence (decreased Lack of Confidence scores) (Table 6). Age 45–54 years (p = 0.012), Master’s Degree (p = 0.039), and household income 50–99 K (p = 0.03) were associated with decreased risk perception (decreased Risk score), while Hispanic (p = 0.0001), African American (p = 0.0012), and Other/Multiple race (p = 0.006) were associated with increased risk perception (Table 7).
For COVID-19 vaccine hesitancy, male sex (p = 0.013), age 45–54 years (p = 0.032), less than High School education (p = 0.014), and household income > 100 K (p = 0.008) were associated with increased confidence (decreased Lack of Confidence score) (Table 8). Declining to state political identification (p = 0.018), African American (p = 0.0001), Hispanic (p = 0.0003), and Other/Multiple race (p = 0.011) respondents had increased risk perception (increased Risk score), whereas higher education such as Master’s Degree (p = 0.009) and Post-graduate Degree (p = 0.025) were associated with decreased risk perception (Table 9).