Objective  To investigate the prevalence and influencing factors of influenza vaccine hesitancy among parents of children in primary/secondary schools and kindergartens in Guiyang city for providing references to influenza prevention in schools and kindergartens.

  Methods  Using two-stage stratified random cluster sampling, we conducted an online survey among 12 338 parents of children from 15 secondary/15 primary schools and 15 kindergartens in Guiyang city, Guizhou province during September 2021. The study adopted a modified questionnaire developed by domestic researchers based on the theory of confidence, complacency, and convenience (“3C”).

  Results  Of the 12 885 respondents (9 538 mothers and 2 747 fathers aged 37.74 ± 7.44 years) with valid replies, 62.27% reported the acceptance of their children′s influenza vaccination; 24.42% expressed neutral attitude towards the vaccination; and 13.13% refused to have their children vaccinated against influenza. Univariate analysis of variance showed that the parents′ influenza vaccine hesitancy was positively correlated with their complacency score (F = 365.061, P < 0.001) but inversely with confidence score (F = 175.758, P < 0.001) and convenience score (F = 71.173, P < 0.001). The results of multivariate linear regression analysis showed that the respondents being mother and having two children were more likely to have a lower confidence in influenza vaccines; the respondents being mother, having two children and with a youngest child of more than 6 years old were more likely to have a higher complacency; the respondents with the education of college and having an average monthly income of more than 5 000 yuan RMB were more likely to have a higher perceived convenience for their children′s vaccination and a lower influenza vaccine hesitancy.

  Conclusion  Based on "3C" model, the parents′ hesitancy for their children′s influenza vaccination is associated with their confidence, complacency, and convenience in the vaccination. The results suggest that measures on improving confidence but reducing complacency in influenza vaccine could be implemented among parents to increase influenza vaccination coverage among children.