The Role of Trauma in Mothers' COVID-19 Vaccine Beliefs and Intentions

Abstract

Objective: Research on COVID-19 vaccine beliefs has focused primarily on adults' intentions to vaccinate themselves; however, many parents will also face decisions about vaccinating their children. In this study, we examine how maternal posttraumatic stress disorder (PTSD) and trauma history relate to mothers' beliefs and intentions about the COVID-19 vaccine for themselves and their children.

Methods: A total of 240 mothers with a mental health history participating in a parenting study answered online survey questions via Prolific. Questions assessed: (a) trauma indictors (past diagnosis, current symptoms, and lifetime exposure to events); (b) vaccine measures (intentions for self and child, COVID-19 vaccine confidence, general vaccine perceived safety, reasoning about vaccine intentions, sources of influence on intentions); and (c) possible explanatory variables (institutional distrust, negative worldviews). ANCOVAs and regression analyses were used.

Results: When compared with mothers with other mental health diagnoses, mothers with a PTSD history had significantly less confidence in the COVID-19 vaccine and less intent to get the vaccine for themselves or their child. These effects were explained by greater institutional distrust (i.e., significant indirect effects). Mothers with a previous PTSD diagnosis also expressed different reasons for vaccine hesitancy (e.g., less belief in science) and ascribed less influence to healthcare and governmental sources in vaccine decision-making.

Conclusion: Findings highlight the potential utility of a trauma-informed approach in efforts to reduce COVID-19 vaccine hesitancy. For mothers with a history of PTSD, addressing institutional distrust, including towards the healthcare industry, may be an important element to consider in the content, delivery, and mode of vaccine messaging.

Keywords: COVID-19; immunology (including HIV); parents; posttraumatic stress trauma.

Figure 1.

Mean scores for COVID-19 vaccine intentions and confidence by posttraumatic stress disorder history (N = 238). Note. Scores are adjusted for covariates, including child age, maternal education, race (African-American), and political affiliation (Republican). All group differences were statistically significant in ANCOVAs: COVID Vaccine Intent—Self, F (1, 230) = 11.16, p < .001; COVID Vaccine Intent—Child, F (1, 230) = 8.87, p < .01; COVID Vaccine Confidence, F (1, 230) = 10.22, p < .01; General Child Vaccine Perceived Safety, F (1, 230) = 6.54, p < .001.

Figure 2.

Standardized path estimates from posttraumatic stress disorder history to vaccine intentions and confidence via benevolent world view and institutional distrust (N = 240). Note. Values on paths reflect standardized estimates from analyses with the three vaccine measure outcomes. For the path from PTSD History to COVID-19 vaccine measures (the c path), the value outside the parentheses reflects the standardized total effect; the value inside the parentheses indicates the standardized direct effect. All values are controlling for child age, maternal education, African-American racial group membership, and Republican party group membership.

Figure 3.

Perceived impact of different sources of information on child vaccine intentions by PTSD history.