Background <p>Understanding if and how vaccination attitudes are shared among family members can help inform strategies to increase uptake. We assessed the correlation of self-reported COVID-19 vaccination attitudes and uptake among Canadian children and their parents, and investigated predictors of parents’ attitudes in January 2021–2022.</p> Methods <p>We studied a subset of 1458 CHILD Cohort Study households where children and parents self-reported their adherence to COVID-19 safety practices, vaccine attitudes and uptake, and health status during the pandemic. Vaccine hesitancy was defined as intending to not receive a COVID-19 vaccine. We identified predictors for vaccine hesitancy using regression and machine learning models and assessed agreement in vaccine intentions between parent–child responses.</p> Results <p>About 4% of adults and 9% of children expressed hesitancy regarding the COVID-19 vaccine, with safety as the primary concern. By the end of the study (Winter 2022), 2% of parents and 13% of children remained unvaccinated. Children’s intentions were largely aligned (over 95%) with their parents’ vaccine uptake. COVID-19 vaccine hesitancy among children was much more common in families with unvaccinated parents (e.g. 48% vs. 5% hesitancy among children of unvaccinated vs. vaccinated mothers, respectively). Unvaccinated adults were less likely to follow COVID-19 safety recommendations and follow their doctor’s vaccine recommendations, and more likely to have general concerns about vaccines.</p> Conclusion <p>This is the first study to describe Canadian children’s and parent’s self-reported COVID-19 vaccine attitudes and intentions. Responses were highly concordant within families. Addressing vaccine hesitancy through understanding its root causes in both children and parents is important for pediatric immunization, both in general and in the context of novel vaccines.</p>