This is part of a continuing series of recommendations put out by CoVaRR-Net. These recommendations are directed to the Federal Deputy Minister of Health, local and provincial Medical Health Officers, Urban Public Health Network, Variant of Concern Expert Panel, school divisions and parents.

The current environment of the COVID-19 pandemic is very fluid. Some of these recommendations may soon be out of date.


Vaccine hesitancy is an important public health concern and a risk to the health of all Canadians.

Reasons for vaccine hesitancy and refusal among children and their parents can differ from adult vaccine hesitancy. A 2019 systematic review and meta-analysis conducted in Michigan indicated fear of needles is common in the majority of children in the studies, including 20 to 50 percent of adolescents.

A study of parents who are hesitant to vaccinate their children indicated that community-level healthcare professionals are the most trusted influence for parental decision making.

There are four principles of biomedical ethics, respect for autonomy, nonmaleficence, beneficence, and justice, that need to be taken into account when balancing the autonomy of the child to vaccinate and the need for a society to build herd immunity.

CoVaRR-Net Recommendations

At the federal level:

  • Fund and support a pan-Canadian evaluation of the provincial/territorial approaches to child vaccine hesitancy to assess the effectiveness of strategies during the COVID-19 pandemic.
  • Develop and support a national framework for vaccine uptake strategies for children and youth.

At the provincial and territorial levels:

  • Follow the evidence-based approach suggested by the Ontario COVID-19 Science Advisory Table by developing resources for healthcare providers. This will entail learning how to navigate COVID-19 vaccine hesitancy conversations, as well as the province or territory setting up a reminder and recall system, and developing public health communication campaigns targeted to children.

At the local and regional levels:

  • Recruit trusted community leaders, members, and healthcare professionals as COVID-19 vaccine ambassadors. Provide additional training, support, and resources for difficult conversations.
  • Work with school divisions/boards to offer school-based vaccination clinics to decrease barriers to access.
  • Provide support to children at the vaccination site to overcome their fear of needles. Colouring books, decorations, therapy dogs, and culturally relevant resources have been used in some provinces and territories to improve vaccination uptake.
  • Marginalized and racialized populations require additional considerations when addressing vaccine hesitancy. Messages must be tailored and should ideally be delivered by community leaders or trusted individuals to effectively address hesitancy.

Read CoVaRR-Net’s full Situation, Background, Assessment and Recommendation (SBAR) document on Vaccine Hesitancy in Children.

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