Foundational Focus Groups

Focus Group Discussion Guide: Parents of Unvaccinated Children 5 to 11 Years Old

Introduction and Ice Breaker (10 min.)

MODERATOR NOTE: Must-hit questions are in bold and should be prioritized if time is limited. Specific notes for moderators are in brackets and are highlighted.

Introduction (4 min.)

Hello, and thank you for speaking with me today. My name is X, and I work for a private research company.

Before we begin, I want to go over a couple of things:

• Your participation is voluntary. If I ask any questions that you do not wish to answer, you do not have to answer them. Also, there are no right or wrong answers here—we just want to know what you think.

• I did not create any of the materials you’ll be reviewing, so I invite you to openly share your thoughts and opinions with me. Your responses won’t affect me either way. Again, my whole reason for being here is to learn about what you think, not to try to sway you.

• There may be times where I ask you to clarify or to tell me more about what you just said. This is simply to make sure I understand and accurately capture what you think, not because I’m challenging your point of view.

• Everything you share here is confidential. Nothing you say will be tied back to you. Your name and any identifying information will not be used in any of our reports.

• There are some other people on the call who are helping me take notes so that I can focus on our conversation.

• I’ll be recording our conversation, and the recordings will be used to confirm our notes, so other project staff may hear the recording at a later date.

  • Do you agree to be recorded? [Receive verbal yes from each participant.]

  • Great! I am going to start the recording now. [Amplify will begin recording.]

• Our discussion should take no more than 90 minutes. I want to be respectful of your time, so I may interrupt occasionally to make sure we can stay on track and get through all of the questions I have today.

• In terms of the flow of our conversation today and what to expect, I’ll start off by asking general questions about your experience with COVID and the pandemic, and then move on to more specific questions about COVID vaccines and your thoughts about COVID vaccines for your children.

Do you have any questions before we begin?

Icebreaker (6 min.)

Great! I’d like to start by getting to know each other a bit more. I can get us started.

[Moderator introduces self. If you don’t have a child but have experiences with children from your family, friends, etc., please use that as your icebreaker and mention what you enjoy doing with them. If you don’t have a child or any experiences with children, feel free to give a fun fact or something you enjoy doing in your free time.]

I have a list of participants, so I’ll call on each of you and you can answer two questions:

• How many children do you have and what are their ages? [Please use this to confirm that they have at least one child who is 5 to 11 years old.]

  • What’s something you enjoy doing with your child or children?

  • [Probe as needed to establish rapport.]

For our discussion today, I’d like you to specifically think of your child who is 5 to 11 years old when answering questions. For those who have multiple children in that age range, you can answer the question for each of your children.

[You may need to remind participants throughout the discussion to answer the questions as they relate to their children who are between 5 and 11 years old.]

COVID-19 and Pandemic Experiences (12 min.)

Now I’m going to ask you about you and your family’s experiences with COVID.

• Thinking back, in what ways has the pandemic affected your life as a parent?

  • Probe: What aspects of being a parent during the pandemic have been the most challenging for you?

• In what ways has the pandemic affected your child’s life?

  • Probe: How has COVID affected their schooling? [Probe for details about school closures, delays in the start of the school year, changes in mask mandates, hybrid learning environment, and vaccine mandates.]

  • [For parents with children older than 11]: What have been some differences between your younger children and your older children when it comes to how the pandemic has affected their lives?

• Have you or anyone you know personally ever had COVID, or thought you had COVID?

  • [If yes] Probe: Was it yourself or someone you know (e.g., child, family member, friend)? What was their experience?

    • [If child had COVID] How have your concerns about COVID changed since your child had it, if at all?

    • [If child has not had it] How concerned are you about the possibility of your young child getting COVID?

  • What are some concerns you have about the health effects of COVID in children?

    • Probe: What kinds of health effects have you heard about?

    • Where did you hear about that? [Probe for specific sources, e.g., doctor, friends, family, online groups, social media, news.]

    • How trustworthy is this source for you?

      • Why?

    • How did you feel when you heard about these health effects?

• What kinds of things are you doing to protect yourself from COVID these days?

  • Probe: Are you masking, staying outdoors, social distancing, etc.?

  • How is this different than when the pandemic first started?

  • How is this different from this time last year?

COVID-19 Vaccine Knowledge and Intention (22 min.)

Next, I’m going to ask you about what you’ve heard about COVID and COVID vaccines, and then get your thoughts and feelings about COVID vaccines for your children.

COVID-19 Vaccine Knowledge, Perceptions, and Information Needs (11 min.)

• How closely would you say you follow the news about COVID vaccines for children ages 5 to 11? (e.g., cases, surges, variants)

  • What have you heard about COVID vaccines for children lately? (Moderators and Notetakers: Make special note of knowledge of vaccine authorization for other groups, e.g., children 6 mo to 4 yo)

  • Where did you hear about that (e.g., news, online, social media, friends and family, doctor)?

  • What are some sources of information that you trust the most?

    • [If participants mention trusting their doctor, physician, pediatrician, etc.] Probe: How long have you been going to your doctor/provider?

    • Probe: Why do you trust those sources?

  • If you were looking for information about COVID vaccines for your children, how would you go about finding it?

• Have you had conversations with a pediatrician or other health care provider about COVID vaccines for your children? [Ask for a show of hands for who has talked to their pediatrician or other health care provider.]

  • [For those who say yes] How did that conversation go?

    • What questions did you have?

    • What did they say about COVID vaccines?

  • [For those who say no] What are some reasons why you haven’t talked with your pediatrician or health care provider about COVID vaccines for your children?

    • [If not answered above] Tell me about who you would prefer to have that conversation with instead of your pediatrician or healthcare professional.

• What additional information about COVID vaccines for children would you want to hear more about, if any?

  • [If data and statistics are mentioned] Probe: What specific data, statistics, or numbers are you interested in (e.g., effectiveness)?

  • [If they mention “data about long-term effects”] Probe: What length of time would data need to be available for (e.g., 3 years, 5 years, 10 years)?

  • Probe: How would knowing [insert stats/data/numbers] encourage you to get your young child vaccinated?

  • What sources would you trust to get this information from?

COVID-19 Vaccination Intention, Concerns, Motivators, and Barriers (11 min.)

• Right now, how likely are you to get your child vaccinated for COVID on a scale of 1 to 5, with 1 being very unlikely and 5 being very likely? [Moderator asks each participant to give rating by indicating the number with their hand and the moderator verbally confirms]

  • Can you tell me why you rated it that way?

  • [For participants who scored 1-4]: What would bring your rating up?

• What are some of your main concerns about COVID vaccines for your children?

  • When did you first become concerned about these issues?

  • What have you heard about them?

  • Where did you hear about them (e.g., friends, family, social media, online)? [Probe for specific sources.]

• What would encourage or motivate you to get your child vaccinated?

  • Probe: If your pediatrician or health care provider recommended getting your child vaccinated, would that motivate you?

    • [If yes] Probe: When would you get your child vaccinated?

    • [If no] Probe: Why not?

• [For parents who are waiting to vaccinate] What are some reasons that you will wait to get your young child a COVID vaccine once they are authorized?

  • How long do you plan to wait to get your young child vaccinated?

  • Probe: Is there a particular amount of time you’re waiting?

  • Probe: Is there a specific milestone or event that you’re waiting for?

Concept Testing and Comparison (44 min.)

Next, I am going to share some initial ideas. I’m going to ask for your feedback for each idea to determine which one you feel would be the best for creating messages that might appear in ads or other materials about COVID vaccines for children ages 5–11.

Please keep in mind that the ideas I’m going to show you today are not fully developed. As we discuss each of these, I’d like you to think about COVID vaccines for your own children.

Concept Testing (33 min.; 11 min. per concept)

[Screen share PowerPoint. There are three concepts. Please ask the following questions for each one.]

[Moderators, please probe as much as possible to ensure we are getting clear and detailed insights for each concept. Please probe into any specific pieces of a concept that may come up. For example, if they mention words or phrases that they don’t like in a concept or if there’s a word or phrase that really stands out to them, probe into the reason (“the why”), and ask about changes they would make.]

• What is your initial reaction to this?

  • [Probe into what they like or don’t like about this idea.]

• What is this idea trying to convey?

  • What makes you say that?

• Does the imagery match what the idea is trying to convey?

  • [If not] What images would convey the main idea?

  • What about the tagline?

    • [Probe into how they may change the tagline.]

• Who do you think this idea is trying to reach?

  • Do you feel this idea is relatable?

    • What is it about this idea specifically that makes you feel that way?

• Do you believe this idea?

  • [Probe into why it is or isn’t believable.]

• On a scale of 1 to 5, with 1 being not convincing and 5 being very convincing, how convincing is this idea as a reason to get your child a COVID vaccine once it is available? [Moderator asks each participant to give rating by indicating the number with their hand and the moderator reads this out.]

  • What about it is convincing?

    • What about it is not convincing?

• What changes, if any, would you make to the ad idea?

  • [If they have specific changes, probe into them, and ask how those changes would make this a better idea. For example, would those changes make this idea more believable or convincing?]

  • [Probe into looking for more information, data, stats, etc. and who they may talk to after seeing this idea.]

Concept Comparison (6 min.)

I’d like you to think about all of the ideas we have discussed today.

• Which idea stood out the most to you?

  • What made it stand out?

  • Is that good, bad, or some combination?

• Which idea resonated the most with you?

  • Which is the most intriguing?

  • Which would drive you to look for more information?

• Which idea would make you the most likely to get your child a COVID vaccine?

  • [If an idea would encourage vaccination, ask the participant to explain why.]

  • [If none of the ideas would encourage vaccination, ask the participant to explain why not.]

Whiteboard Activity (5 min.)

For this last part of our conversation, I’m going to ask all of you to think a bit more creatively. I want you to imagine that you have the opportunity to create messages about COVID vaccines for children. For this activity, again, think about COVID vaccines for your child or children ages 5–11. These messages may appear in ads or other materials. Think of this activity as a brainstorm or “word dump,” so feel free to just say whatever is coming to mind.

[Moderator will type participants’ responses to the first question on the Whiteboard PowerPoint slide.]

• What would you want to see in a message that would make you likely to vaccinate your child?

  • [Moderators, if they’re struggling with this, let them know that this can be words, statements, ideas, etc. that come to mind.]

  • [Probe as to why.]

  • [If there’s time, ask them to make a statement or an idea with what they brainstormed.]

• Next, talk to me about what you wouldn’t want to see in a message, because it would make you less likely to vaccinate your child.

  • [Moderators, if they’re struggling with this, let them know that this can be words, statements, ideas, etc. that come to mind.]

  • [Probe as to why.]

  • [If there’s time, ask them to make a statement or an idea with what they brainstormed.]

Wrap-Up (2 min.)

• Those are all the questions I have for you. I just want to check to see if any of my colleagues have any final questions.

• Is there anything you would like to share that you have not had the chance to before we wrap up?

• I appreciate you sharing your views about COVID-19 and vaccines. As you know, there are a lot of myths and misinformation around this topic being shared. We would encourage you to go to cdc.gov/coronavirus for the latest scientific evidence regarding COVID-19 vaccines. We have also created an FAQ that will be emailed to you following this interview.

• Please remember not to share anything we’ve discussed here today.

• Thank you very much for participating in this discussion. I appreciate your time, and your feedback has been extremely helpful, because it will help the country to deal with the COVID-19 pandemic more effectively.