BACKGROUND: As China expands its national immunization program, it is essential to understand parents' beliefs about pediatric vaccination programs and the translation into actual vaccination decision-making for their children. This study aims to characterize parents pediatric vaccination program preferences and assess the association between parents' reported vaccination preferences and their children's vaccination status. METHODS: In a prospective cohort study in Shanghai, China, we linked parents' survey responses about their preferences for pediatric vaccine programs when the child was ≤ 3 months in 2017 to their children's immunization records in 2020. We classified parents by their vaccination program preferences through a latent class analysis (LCA). Logistic regression analysis was used to explore the association between immunization patterns and respondents' LCA results. RESULTS: The 469 parents were split into four classes: governmental clinic advocates (20%), careful deciders (45%), convenience-focused (19%), and prefer less co-administration (16%). Among the children 66% received combination vaccines, 91% had received at least one imported vaccine, and the average number of office visits by the age of six months was 7. CONCLUSIONS: There were no associations between parents' reported preference categories and children's vaccination patterns. The high acceptance of combination vaccines and tolerance of co-administration gives parents choices for vaccination and impart increased confidence in including new vaccines in the vaccination program.