The present study showed that most parents and their children received COVID-19 vaccine, and COVID-19 vaccine hesitancy was low. Moore et al. found a low rate of vaccination hesitancy among Brazilians [32]. COVID-19 vaccination hesitancy is widespread, ranging from 2.8% in Brazil to 35.2% in Qatar [32, 33]. Furthermore, Altulaihi et al. found that 27% of respondents in Saudi Arabia were hesitant to receive the vaccine [34]. Our previous study showed that most parents were welling to vaccinate their children against COVID-19 vaccine, and COVID-19 vaccine hesitancy was low [10]. Moreover, according to Temsah et al. 47.6% of 3,167 Saudi Arabian parents have decided to vaccinate their children against COVID-19. Inadequate safety information in children and concerns about side effects were the most common reasons for the refusal [10]. Common factors causing hesitation include ambiguity about the need for immunization and uncertainties about vaccine safety and efficacy [35]. Sociodemographic factors related with parental vaccine reluctance vary by place and circumstance [36]. Cognitive biases, personal beliefs, and vaccination as a social contract or norm are highlighted in studies about the psychology of hesitancy and how parents respond to interventions [37]. Presumptive or announced approaches to vaccine recommendations, motivational interviewing, and the use of immunization delivery strategies such as standing orders and reminder/recall programs are evidence-based ways for addressing vaccine hesitancy. Increasing school vaccination requirements can increase vaccination rates, but policy decisions must take local context into account [37].
In our study, more than half of the people reported that their children had adverse effects from their vaccination and that the side effects lasted one to three days. The Centers for Disease Control and Prevention reported that children and teenagers may experience some adverse effects after receiving the COVID-19 vaccination, which may interfere with their ability to do daily activities, but that these side effects should subside within a few days [38]. According to the Saudi Ministry of Health, most vaccine adverse effects are mild to moderate, develop within three days of vaccination, and subside within one to two days [39]. Similar to other vaccines, COVID-19 vaccinations can have side effects, however, the majority of which are minor or moderate and fade away on their own within a few days, according to the World Health Organization [40].
The most reported side effects in our study were pain at the injection site, fever, and tiredness. A systematic review of the safety, immunogenicity, and efficacy of COVID-19 vaccines in children and adolescents showed that COVID-19 vaccines had good safety profiles in children and adolescents and that injection site pain, fatigue, headache, and chest pain were the most common adverse events [41]. According to the Centres for Disease Control and Prevention, the most common side effects observed after receiving the COVID-19 vaccination are mild headaches, pain in the arm where the shot was administered, and tiredness [38]. Furthermore, Alamer et al. conducted a study in Saudi Arabia on the side effects of the COVID-19 Pfizer–BioNTech mRNA Vaccine in children aged between 12 and 18 years old and found that 90% of the children reported redness or pain at the injection site, 67% fatigue, 59% fever, 55% headache, 21% nausea or vomiting, and 20% chest pain and shortness of breath, with only 2% reporting joint or bone pain [28].
According to the CDC's Vaccine Adverse Event Reporting System, more than 90% of post-vaccination adverse event reports among children and young people were not for significant symptoms and included dizziness, fainting, nausea, headache, and fever [38]. Centers for Disease Control and Prevention declared several severe adverse events that could occur after the COVID-19 vaccination, such as anaphylaxis, myocarditis, pericarditis, and Guillain-Barré syndrome, but these are rare [38].
In our study, most vaccine side effects (~ 80%) tend to occur on the first day of vaccination and resolve within 1–2 days. In contrast, long-lasting side effects were noticed in minimal participants of our population (~ 4%). Compared to our study, Kaur R et al. have documented in their systematic review that most COVID-19 vaccine side effects are acute and usually resolved in 3–4 days [42]. Additional studies have reported similar findings of vaccine’s side effects duration like our study [29, 43].
The confidence and trust of the public in vaccines and medications are usually built based on high quality research, ethical, scientific, and professional standards [44]. The ability of scientist and health care providers to provide answers based on scientific evidence are needed to help guide and encourage the public to follow new policies and interventions [44].The result of this study shows that the majority of the side effects are minor and tolerable, which should encourage the public about the safety of receiving the COVID-19 vaccine for children.
There are certain limitations to our research. The first limitation is that because the present study included a self-administered survey, recall bias may affect the replies of the participants. The second limitation is that the participants were not limited to one response per person, which could lead to an overestimation or under-estimation of the presence of side effects. The third limitation is that the study's findings were based on survey data, which means that, like any other cross-sectional study, the results cannot be used to infer causality.
