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Chadwick VL, Saich F, Freeman J, Martiniuk A. Media Discourse Regarding COVID-19 Vaccinations for Children Aged 5 to 11 Years in Australia, Canada, the United Kingdom, and the United States: Comparative Analysis Using the Narrative Policy Framework. JMIR Form Res 2024; 8:e38761. [PMID: 36383344 PMCID: PMC11060323 DOI: 10.2196/38761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 08/08/2022] [Accepted: 08/25/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Media narratives can shape public opinion and actions, influencing the uptake of pediatric COVID-19 vaccines. The COVID-19 pandemic has occurred at a time where infodemics, misinformation, and disinformation are present, impacting the COVID-19 response. OBJECTIVE This study aims to investigate how narratives about pediatric COVID-19 vaccines in the media of 4 English-speaking countries: the United States, Australia, Canada, and the United Kingdom. METHODS The Narrative Policy Framework was used to guide the comparative analyses of the major print and web-based news agencies' media regarding COVID-19 vaccines for children aged 5 to 11 years. Data were sought using systematic searching on Factiva (Dow Jones) of 4 key phases of pediatric vaccine approval and rollout. RESULTS A total of 400 articles (n=287, 71.8% in the United States, n=40, 10% in Australia, n=60, 15% in Canada, and n=13, 3% in the United Kingdom) met the search criteria and were included. Using the Narrative Policy Framework, the following were identified in each article: hero, villain, survivor, and plot. The United States was the earliest country to vaccinate children, and other countries' media often lauded the United States for this. Australian and Canadian media narratives about vaccines for children aged 5 to 11 years were commonly about protecting susceptible people in society, whereas the US and the UK narratives focused more on the vaccine helping children return to school. All 4 countries focused on the vaccines for children aged 5 to 11 years as being key to "ending" the pandemic. Australian and Canadian narratives frequently compared vaccine rollouts across states or provinces and bemoaned local progress in vaccine delivery compared with other countries globally. Canadian and US narratives highlighted the "infodemic" about the COVID-19 pandemic and disinformation regarding child vaccines as impeding uptake. All 4 countries-the United States, Australia, the United Kingdom, and Canada-used war imagery in reporting about COVID-19 vaccines for children. The advent of the Omicron variant demonstrated that populations were fatigued by the COVID-19 pandemic, and the media reporting increasingly blamed the unvaccinated. The UK media narrative was unique in describing vaccinating children as a distraction from adult COVID-19 vaccination efforts. The United States and Canada had narratives expressing anger about potential vaccine passports for children. In Australia, general practitioners were labelled as heroes. Finally, the Canadian narrative suggested altruistic forgoing of COVID-19 vaccine "boosters" as well as pediatric COVID-19 vaccines to benefit those in poorer nations. CONCLUSIONS Public health emergencies require clear; compelling and accurate communication. The stories told during this pandemic are compelling because they contain the classic elements of a narrative; however, they can be reductive and inaccurate.
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Affiliation(s)
- Verity L Chadwick
- Women and Babies Ambulatory Care, Royal Prince Alfred Hospital, Camperdown, Australia
| | - Freya Saich
- Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Joseph Freeman
- Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Alexandra Martiniuk
- Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- The George Institute for Global Health, Sydney, Australia
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Blanchard-Rohner G, Sanchez C, Andre MC, Bressieux-Degueldre S, Grazioli S, Perez MH, Wütz D, Schöbi N, Welzel T, Atkinson A, Schlapbach LJ, Bielicki JA, Trück J. COVID-19 Vaccine Acceptance Among Parents of Children With Multisystem Inflammatory Syndrome in Children. Pediatr Infect Dis J 2024; 43:361-364. [PMID: 38241661 PMCID: PMC10919269 DOI: 10.1097/inf.0000000000004206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/10/2023] [Indexed: 01/21/2024]
Abstract
Data on COVID-19 vaccine acceptability among parents of children with multisystem inflammatory syndrome (MIS-C) are limited. In this cohort of children with MIS-C, enrolled in the Swissped RECOVERY trial (NCT04826588), comparing intravenous immunoglobulins or methylprednisolone, who, in accordance with Swiss guidelines, were recommended for SARS-CoV-2 vaccination, 65% (73/112) of parents reported being vaccinated against SARS-CoV-2 before the MIS-C, while 70% were vaccinated after the MIS-C episode of their child. None of the children were vaccinated before the occurrence of the MIS-C, and only 9% (5/56) received the COVID-19 vaccine after the MIS-C. The predominant barriers to COVID-19 vaccination were concerns over potential side effects and insufficient support from their doctors. This emphasizes the crucial role of health care providers in promoting COVID-19 vaccination among children.
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Affiliation(s)
- Geraldine Blanchard-Rohner
- From the Division of General Pediatrics, Department of Child, Woman and Adolescent Medicine, Pediatric Immunology and Vaccinology Unit, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Carlos Sanchez
- Paediatric Research Centre, University Children’s Hospital Basel, University of Basel, Basel, Swizerland
| | - Maya C. Andre
- Division of Respiratory and Critical Care Medicine, University Children’s Hospital Basel, University of Basel, Basel, Switzerland
- Department of Pediatric Hematology and Oncology, University Children’s Hospital, Eberhard Karls University, Tuebingen, Germany
| | - Sabrina Bressieux-Degueldre
- Department of Women-Mother-Child, Paediatric Cardiology Unit, University Hospital of Lausanne and Lausanne University, Lausanne, Switzerland
| | - Serge Grazioli
- Division of Neonatal and Pediatric Intensive Care, Department of Child, Woman and Adolescent Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Marie-Helene Perez
- Department of Women-Mother-Child, Paediatric Intensive and Intermediate Care Units, University Hospital of Lausanne and Lausanne University, Lausanne, Switzerland
| | - Daniela Wütz
- Division of Pediatric Cardiology, Pediatric Heart Center, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Nina Schöbi
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Tatjana Welzel
- Paediatric Research Centre, University Children’s Hospital Basel, University of Basel, Basel, Swizerland
- Division of Pediatric Rheumatology, University Children’s Hospital Basel, University of Basel, Basel, Switzerland
| | - Andrew Atkinson
- Paediatric Research Centre, University Children’s Hospital Basel, University of Basel, Basel, Swizerland
- Division of Infectious Diseases, Washington University in St. Louis School of Medicine, St. Louis, Missouri
| | - Luregn J. Schlapbach
- Department of Intensive Care and Neonatology, Children`s Research Center, University Children’s Hospital Zurich, Zurich, Switzerland
- Paediatric Intensive Care Unit, Child Health Research Centre, Queensland Children’s Hospital, The University of Queensland, Brisbane, Australia
| | - Julia A. Bielicki
- Centre for Neonatal and Paediatric Infection, St George’s University, London, United Kingdom
| | - Johannes Trück
- Divisions of Allergy and Immunology, Children’s Research Center, University Children’s Hospital Zurich, University of Zurich (UZH), Zurich, Switzerland
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Purvis RS, Moore R, Willis DE, Li J, Selig JP, Kraleti S, Imran T, McElfish PA. Exploring Hesitancy, Motivations, and Practical Issues for COVID-19 Vaccination Among Vaccine-Hesitant Adopter Parents Using the Increasing Vaccination Model. J Pediatr Health Care 2024:S0891-5245(24)00026-9. [PMID: 38430095 DOI: 10.1016/j.pedhc.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 12/12/2023] [Accepted: 01/28/2024] [Indexed: 03/03/2024]
Abstract
INTRODUCTION COVID-19 vaccination coverage among children remains low, and many parents report being hesitant to get their children vaccinated. This study explores factors influencing hesitancy and the facilitators that helped hesitant adopter parents choose to vaccinate their children against COVID-19 despite their hesitancy. METHOD We use a qualitative descriptive design with individual interviews (n = 20) to explore COVID-19 vaccine hesitancy and facilitators of vaccination among hesitant adopter parents. The Increasing Vaccination Model domains (thoughts and feelings, social processes, and practical issues) provided the framework for initial coding, and the research team identified nine emergent themes. RESULTS Findings document the factors influencing hesitancy and the facilitators motivating COVID-19 vaccination among hesitant adopter parents. DISCUSSION Findings fill the gap in the literature by providing hesitant adopters' lived experience, perspectives on vaccine hesitancy, and the influential factors that helped participants overcome their hesitancy and choose to vaccinate their children against COVID-19.
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Moore R, Purvis RS, Willis DE, Li J, Langner J, Gurel-Headley M, Kraleti S, Curran GM, Macechko MD, McElfish PA. "Every Time It Comes Time for Another Shot, It's a Re-Evaluation": A Qualitative Study of Intent to Receive COVID-19 Boosters among Parents Who Were Hesitant Adopters of the COVID-19 Vaccine. Vaccines (Basel) 2024; 12:171. [PMID: 38400154 PMCID: PMC10892107 DOI: 10.3390/vaccines12020171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/20/2024] [Accepted: 01/23/2024] [Indexed: 02/25/2024] Open
Abstract
COVID-19 vaccine coverage remains low for US children, especially among those living in rural areas and the Southern/Southeastern US. As of 12 September 2023, the CDC recommended bivalent booster doses for everyone 6 months and older. Emerging research has shown an individual may be vaccine hesitant and also choose to receive a vaccine for themselves or their child(ren); however, little is known regarding how hesitant adopters evaluate COVID-19 booster vaccinations. We used an exploratory qualitative descriptive study design and conducted individual interviews with COVID-19 vaccine-hesitant adopter parents (n = 20) to explore COVID-19 parental intentions to have children receive COVID-19 boosters. Three primary themes emerged during the analysis: risk, confidence, and intent, with risk assessments from COVID-19 and COVID-19 vaccine confidence often related to an individual parent's intent to vaccinate. We also found links among individuals with persistent concerns about the COVID-19 vaccine and low COVID-19 vaccine confidence with conditional and/or low/no intent and refusal to receive recommended boosters for children. Our findings suggest that healthcare providers and public health officials should continue making strong recommendations for vaccines, continue to address parental concerns, and provide strong evidence for vaccine safety and efficacy even among the vaccinated.
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Affiliation(s)
- Ramey Moore
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR 72762, USA; (R.M.); (R.S.P.); (D.E.W.)
| | - Rachel S. Purvis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR 72762, USA; (R.M.); (R.S.P.); (D.E.W.)
| | - Don E. Willis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR 72762, USA; (R.M.); (R.S.P.); (D.E.W.)
| | - Ji Li
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR 72762, USA
| | - Jonathan Langner
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR 72762, USA;
| | - Morgan Gurel-Headley
- College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR 72205, USA; (M.G.-H.); (S.K.)
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR 72205, USA
| | - Shashank Kraleti
- College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR 72205, USA; (M.G.-H.); (S.K.)
| | - Geoffrey M. Curran
- College of Pharmacy, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR 72205, USA;
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, 4300 W. 7th St., North Little Rock, AR 72114, USA
| | - Michael D. Macechko
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave., Fayetteville, AR 72703, USA;
| | - Pearl A. McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR 72762, USA; (R.M.); (R.S.P.); (D.E.W.)
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Li X, Keown-Stoneman CDG, Anderson LN, Allan K, Fallon BA, Parsons JA, Birken CS, Maguire JL. Factors associated with COVID-19 vaccination in young children. Can J Public Health 2024; 115:40-52. [PMID: 37796366 PMCID: PMC10868559 DOI: 10.17269/s41997-023-00817-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 09/01/2023] [Indexed: 10/06/2023]
Abstract
OBJECTIVE To examine factors associated with COVID-19 vaccination (time to vaccination and vaccination status) among healthy young children participating in primary healthcare. METHODS A cohort study was conducted between November 2021 and September 2022 through the TARGet Kids! primary care research network in Toronto, Canada. Sociodemographic information, child and parent health characteristics, parental vaccine beliefs and child COVID-19 vaccine uptake were collected through parent-reported questionnaires. The primary outcome was time to child COVID-19 vaccination, measured as the time between vaccine availability date and parent-reported child COVID-19 vaccination date. Interval-censored proportional hazard models were used. RESULTS A total of 267 children age 0 to 13 years were included. The mean child age was 7.6 years, 52.8% (n = 141) were male, 66.5% (n = 141) had mothers of European ethnicity (with missingness), and 68.2% (n = 182) of the children were vaccinated. All parents of vaccinated children had received the COVID-19 vaccination themselves. The rate of vaccination for children was 2% higher with each one-month increase in child age (adjusted HR = 1.02, 95%CI = 1.01-1.03, p < 0.001). Compared to children whose parents had uncertain beliefs, those whose parents had positive beliefs about the importance and safety of COVID-19 vaccination for their children had higher rates of vaccination (adjusted HR = 8.29, 95%CI = 4.25-16.17, p < 0.001; adjusted HR = 5.09, 95%CI = 3.17-8.17, p < 0.001). CONCLUSION Older child age, parental COVID-19 vaccination, and positive parental beliefs about COVID-19 vaccination were statistically significantly associated with COVID-19 vaccination among healthy young children. Our findings may help to inform policies, practices, and research which aim to strengthen parental vaccine confidence and promote child COVID-19 vaccination.
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Affiliation(s)
- Xuedi Li
- Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON, Canada.
| | - Charles D G Keown-Stoneman
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Department of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Laura N Anderson
- Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Kate Allan
- Centre for Vaccine Preventable Diseases, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Barbara A Fallon
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Janet A Parsons
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Catherine S Birken
- Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Division of Paediatric Medicine, The Hospital for Sick Children, Toronto, ON, Canada
| | - Jonathon L Maguire
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Department of Pediatrics, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
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Keene K, Balasubramanian A, Potter A, Cioffredi LA. Maternal worry of children contracting COVID-19 predicts vaccine uptake in young children in Vermont. Vaccine X 2024; 16:100442. [PMID: 38318233 PMCID: PMC10839441 DOI: 10.1016/j.jvacx.2024.100442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 01/15/2024] [Accepted: 01/18/2024] [Indexed: 02/07/2024] Open
Abstract
Background Young children, 6 months to 4 years of age, were the last population for whom the COVID-19 vaccines became available and remain the group with the lowest uptake. Scarce information exists on drivers of vaccine uptake in young children. The relationship between parental perceived risk of infection and child COVID-19 vaccination is unknown. Objective Examine the association between perceived risk of infection and early childhood vaccination. Methods In June 2020, perinatal women in Vermont were enrolled in a longitudinal survey study assessing life changes during the pandemic. Surveys included worry of infection, Parents Attitude about Childhood Vaccines (PACV), intention to vaccinate children with the COVID-19 vaccine, and masking behaviors. Once vaccines became available, surveys also included child vaccination status. A demographic-adjusted stepwise logistic regression was conducted to assess the relationship of worry of infection and vaccine hesitancy on child vaccination status. Results 85 women completed baseline and follow up surveys. Participants were highly adherent to adult COVID vaccines with 93 % at least partially vaccinated and only 3 % demonstrated general childhood vaccine hesitancy on the PACV. However, in this highly adherent population, only 61 % of young children are vaccinated. In univariate [OR = 7.35 95 % CI (2.70 to 20.02)] and demographic adjusted [OR = 6.03 95 % CI (1.30 to 27.90)] models, current worry about child infection was associated with higher odds of child vaccination. Previously established predictors, vaccine hesitancy [OR = 0.91 95 % CI (0.84 to 0.99)] and younger maternal age [OR = 1.33 95 % CI (1.07 to 1.65)] were again associated lower odds of child vaccination. Conclusion Among vaccine adherent parents, worry of infection was a strong predictor of vaccine uptake. Continued efforts to articulate the potential morbidity of COVID in young children, along with established methods to address general vaccine hesitancy may aid in COVID vaccine uptake in this population.
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Affiliation(s)
- Kristen Keene
- Vermont Children’s Hospital, Pediatrics, Burlington, VT, United States
| | | | - Alexandra Potter
- Larner College of Medicine at the University of Vermont, Burlington, VT, United States
- University of Vermont, Department of Psychiatry, Burlington, VT, United States
| | - Leigh-Anne Cioffredi
- Vermont Children’s Hospital, Pediatrics, Burlington, VT, United States
- Larner College of Medicine at the University of Vermont, Burlington, VT, United States
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Alexander SM, Lykes JB, Nassef C, Whitham JKE, Ho JG, Donell BB. Multisystem Inflammatory Syndrome in Children: Two Years' Worth of Learning. Clin Pediatr (Phila) 2024; 63:40-46. [PMID: 37309831 PMCID: PMC10696906 DOI: 10.1177/00099228231180411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Multisystem inflammatory syndrome in children (MIS-C) is a life-threatening sequela of SARS-CoV-2 infection. Limited data are available regarding risk-stratification or long-term outcomes in MIS-C. This study sought to determine associations between serologic markers and severity of illness and understand long-term cardiac outcomes. This series includes 46 cases (mean age 8.1 years; 63.0% male) of MIS-C. Pearson's chi-squared analysis showed an erythrocyte sedimentation rate (ESR) greater than 30 mm/h and 50 mm/h were disproportionately associated with pediatric intensive care unit (PICU) admission (χ2 = 4.44, P = .04) and use of vasopressors (χ2 = 6.06, P = .01), respectively. Ferritin less than 175.6 ng/mL was associated with use of vasopressors (χ2 = 5.28, P = .02). There was a negative correlation between ESR and ejection fraction (EF) (r = -0.39, P = .009). Most patients with abnormal echocardiograms had resolution of abnormalities within 30 days. Therefore, inflammatory markers may be helpful in predicting which patients may require specific interventions or experience cardiac dysfunction, but MIS-C does not appear to be associated with complications at 1 year.
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Affiliation(s)
- Seth McKenzie Alexander
- Department of Pediatrics, Division of Pediatric Critical Care and Hospital Medicine, WakeMed Children’s Hospital, Raleigh, NC, USA
- Department of Health Sciences, Division of Radiologic Science, School of Medicine, The University of North Carolina, Chapel Hill, NC, USA
- Department of Pediatrics, The University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - John Bryan Lykes
- Department of Pediatrics, Division of Pediatric Critical Care and Hospital Medicine, WakeMed Children’s Hospital, Raleigh, NC, USA
- Department of Pediatrics, The University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Christopher Nassef
- Department of Pediatrics, Division of Pediatric Critical Care and Hospital Medicine, WakeMed Children’s Hospital, Raleigh, NC, USA
- Department of Pediatrics, The University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Jennifer K. E. Whitham
- Department of Pediatrics, Division of Pediatric Cardiology, WakeMed Children’s Hospital, Raleigh, NC, USA
| | - Jason G. Ho
- Department of Pediatrics, Division of Pediatric Cardiology, WakeMed Children’s Hospital, Raleigh, NC, USA
| | - Bridget B. Donell
- Department of Pediatrics, Division of Pediatric Critical Care and Hospital Medicine, WakeMed Children’s Hospital, Raleigh, NC, USA
- Department of Pediatrics, The University of North Carolina School of Medicine, Chapel Hill, NC, USA
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Stultz JS, Eiland LS. A Review of the Data Supporting Use of COVID-19 Vaccinations in the Pediatric Population. Ann Pharmacother 2023; 57:1328-1340. [PMID: 36847285 PMCID: PMC9974373 DOI: 10.1177/10600280231156625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
OBJECTIVE The objective of this study was to review the effectiveness and safety of COVID-19 vaccinations in the pediatric population. DATA SOURCES PubMed/Medline (September 2020 to December 2022), the Centers for Disease Control and Prevention, and Food and Drug Administration (FDA) websites. STUDY SELECTION AND DATA EXTRACTION Publications regarding the safety and efficacy of COVID-19 vaccinations in children were included. DATA SYNTHESIS Vaccines authorized for use in children include two monovalent mRNA vaccines (≥6 months old) and one monovalent protein subunit adjuvant vaccine (adolescents only). Omicron-specific mRNA bivalent boosters are authorized for children ≥6 months old. Studies after monovalent vaccine authorization illustrated efficacy in children >5 to 6 years of age, specifically decreased severe COVID-19 (including mortality) and multisystem inflammatory response syndrome occurrence (including during Omicron predominance). Available data for children <5 to 6 years suggests efficacy, although data are limited. Monovalent vaccine efficacy against Omicron infections may wane as early as 2 months, but protection against severe disease complications may last longer, and bivalent Omicron boosters are anticipated to increase effectiveness. Myocarditis/pericarditis is a safety concern associated with the COVID-19 vaccinations but occurs less frequently then COVID-19 complications and thus the benefit outweighs the risks. RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE Caregivers seek information from health care professionals regarding vaccine safety and efficacy. Pharmacists can use the objective information in this review to educate caregivers and effectively administer COVID-19 vaccines to patients. CONCLUSIONS There is sufficient and continually growing safety and efficacy data available to recommend COVID-19 vaccinations for children ≥6 months of age.
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Affiliation(s)
- Jeremy S. Stultz
- College of Pharmacy, The University of Tennessee Health Science Center, Memphis, TN, USA
- Le Bonheur Children’s Hospital, Memphis, TN, USA
| | - Lea S. Eiland
- Auburn University Harrison College of Pharmacy, Auburn, AL, USA
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Tu P, Smith D, Parker T, Pejavara K, Michener JL, Lin C. Parent-Child Vaccination Concordance and Its Relationship to Child Age, Parent Age and Education, and Perceived Social Norms. Vaccines (Basel) 2023; 11:1210. [PMID: 37515026 PMCID: PMC10384156 DOI: 10.3390/vaccines11071210] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/21/2023] [Accepted: 06/30/2023] [Indexed: 07/30/2023] Open
Abstract
Researchers established that parental vaccination status often predicts that of their children, but a limited number of studies have examined factors influencing dyadic concordance or discordance (i.e., same or different vaccination status or intent for both members). We investigated how child versus parent age as well as parents' perceptions of their respective friends' immunization behavior impacted un/vaccinated parents' decisions regarding vaccinating their child. An online survey obtained the COVID-19 vaccination status and views of 762 parents of 5-17-year-old children. More than three-quarters of all dyads were concordant; 24.1% of vaccinated parents would not vaccinate their child, with greater hesitancy for younger children and among younger or less educated parents. Children of vaccinated parents and of parents who thought most of their child's friends were vaccinated were 4.7 and 1.9 times, respectively, more likely to be vaccinated; unvaccinated parents were 3.2 times more likely to accept the vaccine for their child if they believed most of their friends would vaccinate their children. Further, parents who reported that most of their friends were vaccinated were 1.9 times more likely to have obtained the vaccine themselves, illustrating the influence of social norms. Regardless of their own vaccination status, parents of unvaccinated children were more likely to be politically conservative. If communities or circles of friends could achieve or convey a vaccinated norm, this might persuade undecided or reluctant parents to vaccinate their children. Future research should examine the effects of community behavior and messages highlighting social norms on pediatric vaccine uptake.
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Affiliation(s)
- Pikuei Tu
- Policy and Organizational Management Program, Duke University, Durham, NC 27708, USA
| | - Danielle Smith
- Policy and Organizational Management Program, Duke University, Durham, NC 27708, USA
| | - Taylor Parker
- Policy and Organizational Management Program, Duke University, Durham, NC 27708, USA
| | - Kartik Pejavara
- Policy and Organizational Management Program, Duke University, Durham, NC 27708, USA
| | - J Lloyd Michener
- Department of Family Medicine & Community Health, Duke University, Durham, NC 27708, USA
| | - Cheryl Lin
- Policy and Organizational Management Program, Duke University, Durham, NC 27708, USA
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Brandenberger J, Duchen R, Lu H, Wanigaratne S, Cohen E, To T, Piché-Renaud PP, Guttmann A. COVID-19 Vaccine Uptake in Immigrant, Refugee, and Nonimmigrant Children and Adolescents in Ontario, Canada. JAMA Netw Open 2023; 6:e2325636. [PMID: 37494039 PMCID: PMC10372706 DOI: 10.1001/jamanetworkopen.2023.25636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 06/13/2023] [Indexed: 07/27/2023] Open
Abstract
Importance COVID-19 vaccinations are recommended for minors. Surveys indicate lower vaccine acceptance by some immigrant and refugee groups. Objective To identify characteristics in immigrant, refugee, and nonimmigrant minors associated with vaccination. Design, Setting, and Participants This retrospective cohort study used linked, population-based demographic and health care data from Ontario, Canada, including all children aged 4 to 17 years registered for universal health insurance on January 1, 2021, across 2 distinct campaigns: for adolescents (ages 12-17 years), starting May 23, 2021, and for children (ages 5-11 years), starting November 25, 2021, through April 24, 2022. Data were analyzed from May 9 to August 2, 2022. Exposures Immigrant or refugee status and immigration characteristics (recency, category, region of origin, and generation). Main Outcomes and Measures Outcomes of interest were crude rates of COVID-19 vaccination (defined as ≥1 vaccination for children and ≥2 vaccinations for adolescents) and adjusted odds ratios (aORs) with 95% CIs for vaccination, adjusted for clinical, sociodemographic, and health system factors. Results The total cohort included 2.2 million children and adolescents, with 1 098 749 children (mean [SD] age, 7.06 [2.00] years; 563 388 [51.3%] males) and 1 142 429 adolescents (mean [SD] age, 14.00 [1.99] years; 586 617 [51.3%] males). Among children, 53 090 (4.8%) were first-generation and 256 886 (23.4%) were second-generation immigrants or refugees; among adolescents, 104 975 (9.2%) were first-generation and 221 981 (19.4%) were second-generation immigrants or refugees, most being economic or family-class immigrants. Immigrants, particularly refugees, were more likely to live in neighborhoods with highest material deprivation (first-generation immigrants: 18.6% of children and 20.2% of adolescents; first-generation refugees: 46.4% of children and 46.3% of adolescents; nonimmigrants: 18.5% of children and 17.2% of adolescents) and COVID-19 risk (first-generation immigrants; 20.0% of children and 20.5% of adolescents; first-generation refugees: 9.4% of children and 12.6% of adolescents; nonimmigrants: 6.9% of children and 6.8% of adolescents). Vaccination rates (53.1% in children and 79.2% in adolescents) were negatively associated with material deprivation. In both age groups, odds for vaccination were higher in immigrants (children: aOR, 1.30; 95% CI, 1.27-1.33; adolescents: aOR, 1.10; 95% CI, 1.08-1.12) but lower in refugees (children: aOR, 0.34; 95% CI, 0.33-0.36; adolescents: aOR, 0.88; 95% CI, 0.84-0.91) compared with nonimmigrants. In immigrant- and refugee-only models stratified by generation, region of origin was associated with uptake, compared with the overall rate, with the lowest odds observed in immigrants and refugees from Eastern Europe (children: aOR, 0.40; 95% CI, 0.35-0.46; adolescents: aOR, 0.41; 95% CI, 0.38-0.43) and Central Africa (children: aOR, 0.24; 95% CI, 0.16-0.35; adolescents: aOR, 0.51,CI: 0.45-0.59) and the highest odds observed in immigrants and refugees from Southeast Asia (children: aOR, 2.68; 95% CI, 2.47-2.92; adolescents aOR, 4.42; 95% CI, 4.10-4.77). Adjusted odds of vaccination among immigrants and refugees from regions with lowest vaccine coverage were similar across generations. Conclusions and Relevance In this cohort study using a population-based sample in Canada, nonrefugee immigrants had higher vaccine coverage than nonimmigrants. Substantial heterogeneity by region of origin and lower vaccination coverage in refugees persisted across generations. These findings suggest that vaccine campaigns need precision public health approaches targeting specific barriers in identified, undervaccinated subgroups.
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Affiliation(s)
- Julia Brandenberger
- Edwin S.H. Leong Centre for Healthy Children, University of Toronto, Toronto, Ontario, Canada
- Division of Pediatric Emergency Medicine, Hospital for Sick Children, Toronto, Ontario, Canada
- Pediatric Emergency Department, University Hospital of Bern, Bern, Switzerland
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada
| | | | - Hong Lu
- ICES, Toronto, Ontario, Canada
| | - Susitha Wanigaratne
- Edwin S.H. Leong Centre for Healthy Children, University of Toronto, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
| | - Eyal Cohen
- Edwin S.H. Leong Centre for Healthy Children, University of Toronto, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Division of Paediatric Medicine, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Teresa To
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Pierre-Philippe Piché-Renaud
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
- Division of Pediatric Infectious Diseases, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Astrid Guttmann
- Edwin S.H. Leong Centre for Healthy Children, University of Toronto, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Division of Paediatric Medicine, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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11
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Andersen JA, Scott AJ, Rowland B, Willis DE, McElfish PA. Associations between COVID-19 Death Exposure and COVID-19 Vaccine Hesitancy and Vaccine Uptake. South Med J 2023; 116:519-523. [PMID: 37400094 DOI: 10.14423/smj.0000000000001576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Abstract
OBJECTIVES The aim of the study was to determine the relation between coronavirus disease 2019 (COVID-19) death exposure and COVID-19 vaccine hesitancy and vaccine uptake among Arkansans, controlling for sociodemographic factors. METHODS Data were collected from a telephone survey administered in Arkansas between July 12 and July 30, 2021 (N = 1500) via random digit dialing of telephone landlines and cellular telephones. Weighted data were used to estimate regressions. RESULTS Controlling for sociodemographic variables, COVID-19 death exposure was not a significant predictor of COVID-19 vaccine hesitancy (P = 0.423) or COVID-19 vaccine uptake (P = 0.318). Younger individuals, those with lower levels of education, and those who live in rural counties were more likely to be COVID-19 vaccine hesitant. Older individuals, Hispanic/Latinx individuals, those who reported higher levels of education, and those who reported living in urban counties were more likely to have reported receiving the COVID-19 vaccine. CONCLUSIONS Many efforts to promote COVID-19 vaccines have focused on prosocial norms, including encouraging vaccination to protect the community from COVID-19 infection and death; however, COVID-19 death exposure was not related to COVID-19 vaccine hesitancy or uptake in the present study. Future research should examine whether prosocial messaging is effective in decreasing hesitancy or motivating some individuals to receive the vaccine among those who have been exposed to COVID-19 deaths.
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Affiliation(s)
| | - Aaron J Scott
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Springdale
| | - Brett Rowland
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Springdale
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12
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Kang JH, Kim Y. Factors influencing COVID-19 vaccination intention among parents of children aged 5-11 years in South Korea: a cross-sectional study. Child Health Nurs Res 2023; 29:237-247. [PMID: 37554091 PMCID: PMC10415840 DOI: 10.4094/chnr.2023.29.3.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/14/2023] [Accepted: 07/15/2023] [Indexed: 08/10/2023] Open
Abstract
PURPOSE The purpose of this study was to identify factors affecting parents' intentions to have their children aged 5-11 years vaccinated against coronavirus disease 2019 (COVID-19). METHODS The participants of the study were 298 parents with children aged 5-11 years in South Korea. Data collection took place from October 20 to October 26, 2022 and used an online survey (Google Forms). Data were analyzed using descriptive statistics, the t test, analysis of variance, the Scheffé test, Pearson correlation coefficients, and hierarchical regression in IBM SPSS version 26.0. RESULTS The factors influencing participants' vaccination intentions for their children aged 5-11 years were cognitive behavioral control (β=.40, p<.001), attitudes (β=.37, p<.001), subjective norms (β=.20, p<.001), and awareness of whether their child could receive the COVID-19 vaccine (β=.07, p=.016). The explanatory power of the regression equation was 89%. CONCLUSION Parents' intentions to vaccinate their children against COVID-19 are influenced by their attitudes, subjective norms, and perceived behavioral control toward vaccines. Since parents are concerned about vaccine side effects, it is important to establish a trusted line of communication to keep them informed about vaccinations.
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Affiliation(s)
- Jung Hwa Kang
- Graduate Student, Department of Nursing, Catholic Kwandong University College of Medicine, Gangneung, Korea
| | - Yunsoo Kim
- Assistant Professor, Department of Nursing, Catholic Kwandong University College of Medicine, Gangneung, Korea
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13
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Ryan GW, Goulding M, Borg A, Minkah P, Beeler A, Rosal MC, Lemon SC. Development and Beta-Testing of the CONFIDENCE Intervention to Increase Pediatric COVID-19 Vaccination. J Pediatr Health Care 2023; 37:244-252. [PMID: 36470798 PMCID: PMC9671697 DOI: 10.1016/j.pedhc.2022.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 11/11/2022] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Innovative strategies are needed to improve pediatric COVID-19 vaccination rates. We describe the process for developing a clinic-based intervention, CONFIDENCE, to improve pediatric COVID-19 vaccine uptake and present results of our beta-test for feasibility and acceptability. METHOD CONFIDENCE included communication training with providers, a poster campaign, and parent-facing educational materials. We assessed feasibility and acceptability through interviews and measured preliminary vaccine intention outcomes with a pre-post parent survey. Interviews were analyzed using rapid qualitative methods. We generated descriptive statistics for variables on the parent survey and used Fisher's exact test to assess pre-post differences. RESULTS Participating providers (n = 4) reported high levels of feasibility and acceptability. We observed positive trends in parents' (n = 69) reports of discussing vaccination with their provider and the parental decision to accept COVID-19 vaccination. DISCUSSION Our next steps will be to use more rigorous methods to establish the efficacy and effectiveness of the CONFIDENCE intervention.
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14
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Baysson H, Pullen N, De Mestral C, Semaani C, Pennacchio F, Zaballa ME, L'Huillier AG, Lorthe E, Guessous I, Stringhini S. Parental willingness to have children vaccinated against COVID-19 in Geneva, Switzerland: a cross-sectional population-based study. Swiss Med Wkly 2023; 153:40049. [PMID: 37011595 DOI: 10.57187/smw.2023.40049] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Indexed: 04/05/2023] Open
Abstract
OBJECTIVE We aimed to examine factors associated with parental willingness to vaccinate their children against COVID-19. METHODS We surveyed adults included in a digital longitudinal cohort study composed of participants in previous SARS-CoV-2 serosurveys conducted in Geneva, Switzerland. In February 2022, an online questionnaire collected information on COVID-19 vaccination acceptance, parental willingness to vaccinate their children aged ≥5 years and reasons for vaccination preference. We used multivariable logistic regression to assess the demographic, socioeconomic and health-related factors associated with being vaccinated and with parental intention to vaccinate their children. RESULTS We included 1,383 participants (56.8% women; 69.3% aged 35-49 years). Parental willingness to vaccinate their children increased markedly with the child's age: 84.0%, 60.9% and 21.2%, respectively, for parents of adolescents aged 16-17 years, 12-15 years and 5-12 years. For all child age groups, unvaccinated parents more frequently indicated not intending to vaccinate their children than vaccinated parents. Refusal to vaccine children was associated with having a secondary education (1.73; 1.18-2.47) relative to a tertiary education and with middle (1.75; 1.18-2.60) and low (1.96; 1.20-3.22) household income relative to high income. Refusal to vaccine their children was also associated with only having children aged 12-15 years (3.08; 1.61-5.91), aged 5-11 years (19.77; 10.27-38.05), or in multiple age groups (6.05; 3.22-11.37), relative to only having children aged 16-17 years. CONCLUSION Willingness to vaccinate children was high for parents of adolescents aged 16-17 years but decreased significantly with decreasing child age. Unvaccinated, socioeconomically disadvantaged parents and those with younger children were less likely to be willing to vaccinate their children. These results are important for vaccination programs and developing communication strategies to reach vaccine-hesitant groups, both in the context of COVID-19 and in the prevention of other diseases and future pandemics.
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Affiliation(s)
- Hélène Baysson
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Nick Pullen
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Carlos De Mestral
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Claire Semaani
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Francesco Pennacchio
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - María-Eugenia Zaballa
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Arnaud G L'Huillier
- Pediatric Infectious Diseases Unit, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Elsa Lorthe
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Idris Guessous
- Department of Health and Community Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Silvia Stringhini
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
- Department of Health and Community Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- University Center for General Medicine and Public Health, University of Lausanne, Lausanne, Switzerland
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15
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Hammershaimb EA, Campbell JD, O'Leary ST. Coronavirus Disease-2019 Vaccine Hesitancy. Pediatr Clin North Am 2023; 70:243-257. [PMID: 36841593 PMCID: PMC9729588 DOI: 10.1016/j.pcl.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Early in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, before coronavirus disease-2019 (COVID-19) vaccines were authorized, surveys began tracking public acceptance of a hypothetical COVID-19 vaccine. As vaccines became more widely available, the focus shifted from evaluating premeditative thoughts about COVID-19 vaccines to observing behaviors, measuring uptake, and characterizing factors associated with acceptance. A wealth of peer-reviewed literature examining the complexities of COVID-19 vaccine acceptance has emerged, but our understanding of COVID-19 vaccine acceptance is constantly evolving. In this article, we review the current state of knowledge regarding COVID-19 vaccine hesitancy, with an emphasis on pediatric vaccination.
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Affiliation(s)
- E Adrianne Hammershaimb
- Division of Infectious Diseases and Tropical Pediatrics, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA; Center for Vaccine Development and Global Health, University of Maryland, School of Medicine, Health Sciences Research Facility 1, Research Facility 1, Room 480, 685 West Baltimore Street, Baltimore, MD 21201, USA
| | - James D Campbell
- Division of Infectious Diseases and Tropical Pediatrics, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA; Center for Vaccine Development and Global Health, University of Maryland, School of Medicine, Health Sciences Research Facility 1, Research Facility 1, Room 480, 685 West Baltimore Street, Baltimore, MD 21201, USA
| | - Sean T O'Leary
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, F443, 1890 North Revere Court, Aurora, CO 80045, USA.
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16
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Krieger E, Sharashova E, Kudryavtsev AV, Samodova O, Kontsevaya A, Brenn T, Postoev V. COVID-19: seroprevalence and adherence to preventive measures in Arkhangelsk, Northwest Russia. Infect Dis (Lond) 2023; 55:316-327. [PMID: 36919829 DOI: 10.1080/23744235.2023.2179660] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND The published estimates of SARS-CoV-2 seroprevalence in Russia are few. The study aimed to assess the SARS-CoV-2 seroprevalence in Arkhangelsk (Northwest Russia), in a year after the start of the pandemic, to evaluate the population adherence to non-pharmaceutical interventions (NPIs), and to investigate characteristics associated with COVID-19 seropositive status. METHODS We conducted a SARS-CoV-2 seroprevalence study between 24 February and 30 June 2021 involving 1332 adults aged 40-74 years. Logistic regression models were fit to identify factors associated with seropositive status and with adherence to NPIs. RESULTS Less than half (48.9%) of study participants adhered all recommended NPIs. Male sex (odds ratio [OR] 1.7, 95% confidence intervals [CI] 1.3; 2.3), regular employment (OR 1.8, 95% CI 1.3; 2.5) and low confidence in the efficiency of the NPIs (OR 1.9, 95% CI 1.5; 2.5) were associated with low adherence to internationally recommended NPIs. The SARS-CoV-2 seroprevalence rate was 65.1% (95% CI: 62.5; 67.6) and increased to 73.0% (95% CI: 67.1; 85.7) after adjustment for test performance. Regular employment (OR 2.0, 95% CI 1.5; 2.8) and current smoking (OR 0.4, 95% CI 0.2; 0.5) were associated with being seropositive due to the infection. CONCLUSIONS Two third of the study population were seropositive in a year after the onset of the pandemic in Arkhangelsk. Individuals with infection-acquired immunity were more likely to have regular work and less likely to be smokers. The adherence to NPIs was not found associated with getting the virus during the first year of the pandemic.
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Affiliation(s)
- Ekaterina Krieger
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.,International Research Competence Centre, Northern State Medical University, Arkhangelsk, Russian Federation
| | - Ekaterina Sharashova
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Alexander V Kudryavtsev
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.,International Research Competence Centre, Northern State Medical University, Arkhangelsk, Russian Federation
| | - Olga Samodova
- Department of Infectious Diseases, Northern State Medical University, Arkhangelsk, Russian Federation
| | - Anna Kontsevaya
- Department of Public Health, National Medical Research Centre for Therapy and Preventive Medicine, Moscow, Russian Federation
| | - Tormod Brenn
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Vitaly Postoev
- Department of Research Methodology, Northern State Medical University, Arkhangelsk, Russian Federation
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17
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Hart RJ, Baumer-Mouradian S, Bone JN, Olson P, Schroter S, Weigert RM, Chung S, Shah P, Lunoe MM, Evers M, Nelson CE, Goldman RD. Factors associated with US caregivers' uptake of pediatric COVID-19 vaccine by race and ethnicity. Vaccine 2023; 41:2546-2552. [PMID: 36906408 PMCID: PMC9986131 DOI: 10.1016/j.vaccine.2023.02.080] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 02/26/2023] [Indexed: 03/08/2023]
Abstract
OBJECTIVES To assess differences in willingness to vaccinate children against COVID-19, and factors that may be associated with increased acceptance, among US caregivers of various racial and ethnic identities who presented with their child to the Emergency Department (ED) after emergency use authorization of vaccines for children ages 5-11. STUDY DESIGN A multicenter, cross-sectional survey of caregivers presenting to 11 pediatric EDs in the United States in November-December 2021. Caregivers were asked about their identified race and ethnicity and if they planned to vaccinate their child. We collected demographic data and inquired about caregiver concerns related to COVID-19. We compared responses by race/ethnicity. Multivariable logistic regression models served to determine factors that were independently associated with increased vaccine acceptance overall and among racial/ethnic groups. RESULTS Among 1916 caregivers responding, 54.67% planned to vaccinate their child against COVID-19. Large differences in acceptance were noted by race/ethnicity, with highest acceptance among Asian caregivers (61.1%) and those who did not specify a listed racial identity (61.1%); caregivers identifying as Black (44.7%) or Multi-racial (44.4%) had lower acceptance rates. Factors associated with intent to vaccinate differed by racial/ethnic group, and included caregiver COVID-19 vaccine receipt (all groups), caregiver concerns about COVID-19 (White caregivers), and having a trusted primary provider (Black caregivers). CONCLUSIONS Caregiver intent to vaccinate children against COVID-19 varied by race/ethnicity, but race/ethnicity did not independently account for these differences. Caregiver COVID-19 vaccination status, concerns about COVID-19, and presence of a trusted primary provider are important in vaccination decisions.
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Affiliation(s)
- Rebecca J Hart
- Department of Pediatrics, Norton Children's and University of Louisville School of Medicine, Louisville, KY, USA.
| | | | - Jeffrey N Bone
- Department of Pediatrics, University of British Columbia, Children's Hospital Vancouver, Canada
| | - Prasra Olson
- Department of Pediatrics, Children's Hospital Los Angeles, University of Southern California, Los Angeles, CA, USA
| | - Stephanie Schroter
- Department of Pediatrics, Rady Children's Hospital San Diego and University of California, San Diego, San Diego, CA, USA
| | - Rachel M Weigert
- Depatrment of Pediatric Emergency Medicine, Children's Minnesota, Minneapolis, MN, USA
| | - SunHee Chung
- Department of Emergency Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Pareen Shah
- Department of Pediatric Emergency Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Maren M Lunoe
- Department of Pediatrics, University of Pittsburgh and UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Megan Evers
- Department of Pediatrics, University Hospitals Cleveland Medical Center, Rainbow Babies and Children's Hospital, Cleveland, OH, USA
| | - Courtney E Nelson
- Department of Pediatrics, Nemours Children's Hospital - Delaware Wilmington, DE, USA
| | - Ran D Goldman
- The Pediatric Research in Emergency Therapeutics (PRETx) Program, Division of Emergency Medicine, Department of Pediatrics, University of British Columbia and BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
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18
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Allen JD, Matsunaga M, Lim E, Zimet GD, Nguyen KH, Fontenot HB. Parental Decision Making Regarding COVID-19 Vaccines for Children under Age 5: Does Decision Self-Efficacy Play a Role? Vaccines (Basel) 2023; 11:478. [PMID: 36851355 PMCID: PMC9959902 DOI: 10.3390/vaccines11020478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/31/2023] [Accepted: 02/13/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND COVID-19 vaccines are now available under Emergency Use Authorization for children ages 6 months to 5 years. We examined parents' intentions to vaccinate their children under the age of 5 years and assessed whether their confidence in making an informed decision about vaccination (decision self-efficacy) was associated with these intentions. METHOD We conducted a cross-sectional online survey of U.S. parents between 23 March and 5 April 2022. We examined associations between parental intention to vaccinate their young children ( RESULTS Of the 591 parents in this sample, 49% indicated that they intended to vaccinate their child(ren), 29% reported that they would not, and 21% were undecided. In bivariate analyses, race/ethnicity, health insurance, flu vaccination in the past 12 months, and parental COVID-19 vaccination status were significantly related to parental intention to vaccinate their child(ren). In the multivariable analyses, which controlled for these factors, parents who intended to vaccinate their child(ren) had greater confidence in their ability to make informed decisions about COVID-19 vaccinations compared to those who were unsure about vaccination. Each one standard deviation in the Decision Self-Efficacy score was associated with a 39% increase in intention to vaccinate one's child versus being unsure about vaccination (AOR 1.39, 95% CI 1.09, 1.77). CONCLUSIONS Parents who are unsure about vaccinating their children against COVID-19 may benefit from interventions designed to increase their ability to obtain, understand, and utilize information to make informed decisions.
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Affiliation(s)
- Jennifer D. Allen
- Department of Community Health, Tufts University School of Arts and Sciences, 574 Boston Ave, Medford, MA 02155, USA
| | - Masako Matsunaga
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI 96813, USA
| | - Eunjung Lim
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI 96813, USA
| | - Gregory D. Zimet
- Department of Pediatrics, Indiana University School of Medicine, 410 West 10th Street, Suite 1001, Indianapolis, IN 46202, USA
| | - Kimberly H. Nguyen
- Department of Public Health and Community Medicine, Tufts University Medical School, 136 Harrison Ave, Boston, MA 02111, USA
| | - Holly B. Fontenot
- Nancy Atmospera-Walch School of Nursing, University of Hawaii at Manoa, 2528 McCarthy Mall, Webster Hall, Honolulu, HI 96822, USA
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19
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Murthy BP, Fast HE, Zell E, Murthy N, Meng L, Shaw L, Vogt T, Chatham-Stephens K, Santibanez TA, Gibbs-Scharf L, Harris LQ. COVID-19 Vaccination Coverage and Demographic Characteristics of Infants and Children Aged 6 Months-4 Years - United States, June 20-December 31, 2022. MMWR Morb Mortal Wkly Rep 2023; 72:183-189. [PMID: 36795658 PMCID: PMC9949848 DOI: 10.15585/mmwr.mm7207a4] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Although severe COVID-19 illness and hospitalization are more common among older adults, children can also be affected (1). More than 3 million cases of COVID-19 had been reported among infants and children aged <5 years (children) as of December 2, 2022 (2). One in four children hospitalized with COVID-19 required intensive care; 21.2% of cases of COVID-19-related multisystem inflammatory syndrome in children (MIS-C) occurred among children aged 1-4 years, and 3.2% of MIS-C cases occurred among infants aged <1 year (1,3). On June 17, 2022, the Food and Drug Administration issued an Emergency Use Authorization (EUA) of the Moderna COVID-19 vaccine for children aged 6 months-5 years and the Pfizer-BioNTech COVID-19 vaccine for children aged 6 months-4 years. To assess COVID-19 vaccination coverage among children aged 6 months-4 years in the United States, coverage with ≥1 dose* and completion of the 2-dose or 3-dose primary vaccination series† were assessed using vaccine administration data for the 50 U.S. states and District of Columbia submitted from June 20 (after COVID-19 vaccine was first authorized for this age group) through December 31, 2022. As of December 31, 2022, ≥1-dose COVID-19 vaccination coverage among children aged 6 months-4 years was 10.1% and was 5.1% for series completion. Coverage with ≥1 dose varied by jurisdiction (range = 2.1% [Mississippi] to 36.1% [District of Columbia]) as did coverage with a completed series (range = 0.7% [Mississippi] to 21.4% [District of Columbia]), respectively. By age group, 9.7 % of children aged 6-23 months and 10.2% of children aged 2-4 years received ≥1 dose; 4.5% of children aged 6-23 months and 5.4% of children aged 2-4 years completed the vaccination series. Among children aged 6 months-4 years, ≥1-dose COVID-19 vaccination coverage was lower in rural counties (3.4%) than in urban counties (10.5%). Among children aged 6 months-4 years who received at least the first dose, only 7.0% were non-Hispanic Black or African American (Black), and 19.9% were Hispanic or Latino (Hispanic), although these demographic groups constitute 13.9% and 25.9% of the population, respectively (4). COVID-19 vaccination coverage among children aged 6 months-4 years is substantially lower than that among older children (5). Efforts are needed to improve vaccination coverage among children aged 6 months-4 years to reduce COVID-19-associated morbidity and mortality.
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Vatcharavongvan P, Boonyanitchayakul N, Khampachuea P, Sinturong I, Prasert V. Health Belief Model and parents' acceptance of the Pfizer-BioNTech and Sinopharm COVID-19 vaccine for children aged 5-18 years Old: A national survey. Vaccine 2023; 41:1480-9. [PMID: 36707336 DOI: 10.1016/j.vaccine.2023.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 01/24/2023]
Abstract
BACKGROUND During the COVID-19 pandemic, several vaccines received approval for children aged 18 or younger. Parents' decisions to accept vaccines play an important role in the success of vaccination campaigns. The Health Belief Model (HBM) may explain its association with vaccine acceptance. This study examined parents' Pfizer-BioNTech and Sinopharm vaccine acceptance for their children and its association with HBM. METHODS A cross-sectional study was conducted in March 2022 using an online survey. Respondents were parents of children aged 5-18 in public and private schools. The multistage random sampling technique was used to choose schools and respondents. Multivariable analysis was conducted to examine the association between vaccine acceptance and HBM. RESULTS The response rate was 55 %. Of 1,056 respondents, 80.1 % were female, with a mean age of 41, and 95.8 % were not health professionals. Pfizer-BioNTech had a greater acceptance rate than Sinopharm (90 % v.s. 36 %). The Multivariable analysis shows that perceived benefits (aOR = 25.30, 95 %CI = 10.02-63.89 and aOR = 17.94, 95 %CI = 9.56-33.66 for Pfizer-BioNTech and Sinopharm, respectively) and perceived barriers (aOR = 0.06, 95 %CI = 0.01-0.50 and aOR = 0.20, 95 %CI = 0.11-0.40 for Pfizer-BioNTech and Sinopharm, respectively) were associated with vaccine acceptance for both vaccines. Education was associated with Pfizer-BioNTech vaccine acceptance (aOR = 0.96, 95 %CI 0.71-1.29). CONCLUSIONS The respondents were more confident in Pfizer-BioNTech than Sinopharm. Perceived barriers and perceived benefits were strongly associated with the respondents' vaccine acceptance for both vaccines. During epidemics and pandemics, the government needs vaccines with high efficacy and safety for a higher chance of parents' vaccine acceptance. Future research should examine vaccine costs as perceived barriers for a newly out-of-pocket developed vaccine.
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Burkhardt MC, Berset AE, Xu Y, Mescher A, Brinkman WB. Effect of Outreach Messages on Adolescent Well-Child Visits and Coronavirus Disease 2019 Vaccine Rates: A Randomized, Controlled Trial. J Pediatr 2023; 253:158-164.e1. [PMID: 36202236 PMCID: PMC9529346 DOI: 10.1016/j.jpeds.2022.09.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 08/26/2022] [Accepted: 09/23/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To determine effectiveness of text/telephone outreach messages, with and without coronavirus disease 2019 (COVID-19) vaccine information. STUDY DESIGN We conducted an intent-to-treat, multiarm, randomized clinical trial with adolescents aged 12-17 years. Eligible patients did not have an adolescent well-care visit in the past year or scheduled in the next 45 days or an active electronic health record portal account. We randomized participants to the standard message, COVID-19 vaccine message, or no message (control) group and delivered 2 text messages or telephone calls (per family preference) to the message groups. The primary outcome was adolescent well-care visit completion within 8 weeks, and secondary outcomes were adolescent well-care visit scheduled within 2 weeks and receiving COVID-19 vaccine within 8 weeks. RESULTS We randomized 1235 adolescents (mean age, 14 ± 1.5 years; 51.6% male; 76.7% Black; 4.1% Hispanic/Latinx; 88.3% publicly insured). The standard message group had higher odds of scheduling an adolescent well-care visit compared with the control group (OR, 2.07; 95% CI, 1.21-3.52) and COVID-19 vaccine message group (OR, 1.66; 95% CI, 1.00-2.74). The odds of completing an adolescent well-care visit did not differ significantly (standard message group vs control group; OR, 1.35; 95% CI, 0.88-2.06; COVID-19 vaccine message group vs control group, OR, 1.33; 95% CI, 0.87-2.03). In per-protocol analyses, adolescents in the standard message group were twice as likely as the control group to receive the COVID-19 vaccine (OR, 2.48; 95% CI, 1.05-5.86). CONCLUSIONS Outreach messages were minimally effective. Efforts are needed to address widening disparities. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov: NCT04904744.
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Affiliation(s)
- Mary Carol Burkhardt
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH; Division of General & Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
| | - Anne E Berset
- Division of General & Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Yingying Xu
- Division of General & Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Anne Mescher
- Division of General & Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - William B Brinkman
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH; Division of General & Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
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Darisi RD, Buckland AJ, Morales M, Ingram M, Harris E, Holzberg JR. Vaccine hesitancy and the willingness to recommend the COVID-19 vaccine to children in a rural country on the United States-Mexico border. Front Public Health 2023; 11:1127745. [PMID: 37206870 PMCID: PMC10189097 DOI: 10.3389/fpubh.2023.1127745] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 04/06/2023] [Indexed: 05/21/2023] Open
Abstract
Introduction As of October 26, 2022, only 9% of children in the United States aged 6 months to 4 years have received at least one dose of COVID-19 vaccine despite FDA approval since June 17, 2022. Rates are better yet still low for children aged 5 to 11 years as nearly 30% were fully vaccinated as of August 23, 2022. Vaccine hesitancy among adults is one of the major factors affecting low vaccine uptake rates in children against COVID-19, yet most studies examining vaccine hesitancy have targeted school-age and adolescent children. Methods With the aim of assessing the willingness to recommend the COVID-19 vaccination to children under 5 years compared to children 5 to 12 years of age, a county-wide survey was conducted between January 11 and March 7, 2022, among adults on the United States-Mexico border. Results Among the 765 responses, 72.5% were female and 42.3% were Latinx. The most significant factor associated with likelihood to recommend the COVID-19 vaccine to children less than 5 years and 5-12 years of age was adult vaccination status. Ordinal logistic regression also indicated that ethnicity, primary language, being a parent, previous COVID-19 infection, and concern about getting COVID-19 in the future were significantly associated with likelihood of COVID-19 vaccine recommendation to children < 5 years and 5-12 years old. Discussion This study found high consistency among respondents in their willingness to vaccinate children aged < 5 years compared with children aged 5-12 years. Our findings support public health strategies that target adult vaccinations as an avenue to improve childhood vaccinations for young children.
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Affiliation(s)
- Raghu D. Darisi
- Chiricahua Community Health Centers, Inc., Douglas, AZ, United States
| | - Audrey J. Buckland
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Mario Morales
- Health Behavior Health Promotion, University of Arizona, Tucson, AZ, United States
| | - Maia Ingram
- Arizona Prevention Research Center, College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Emily Harris
- Chiricahua Community Health Centers, Inc., Douglas, AZ, United States
| | - Jeffrey R. Holzberg
- Chiricahua Community Health Centers, Inc., Douglas, AZ, United States
- *Correspondence: Jeffrey R. Holzberg,
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Nickerson A, Gutierrez-Mock L, Buback L, Welty S, Anicete LM, Sanchez S, Enanoria WTA, Reid M. Factors Influencing Parent and Guardian Decisions on Vaccinating Their Children Against SARS-CoV-2: A Qualitative Study. Inquiry 2023; 60:469580231159742. [PMID: 36941747 PMCID: PMC10031620 DOI: 10.1177/00469580231159742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
This qualitative analysis sought to explore factors that influenced parent/guardian intentions to vaccinate their children against SARS-CoV-2 in San Francisco, California, USA in order to inform San Francisco Department of Public Health's (SFDPH) youth vaccine rollout program. 30-minute, semi-structured telephone interviews were conducted with parents and guardians in either Spanish or English. Respondents shared their perspectives on vaccinating their children against SARS-CoV-2. Interviews were conducted over the telephone and recorded on Zoom. Participants (n = 40) were parents/guardians responding on behalf of their adolescent children (age 13+) and parents/guardians identified from the SFDPH COVID-19 testing database who tested for SARS-CoV-2 within the last 2 weeks. Interviews were conducted, audio recorded, transcribed, translated into English as appropriate, and rapidly analyzed in REDCap according to matrix analysis methodology to develop parent study themes. Perspectives on child vaccination were then explored through thematic analysis. Three themes were identified from the thematic analysis: (1) parental desires for children to return to school safely, (2) unclear messaging and information on COVID-19 prevention and vaccination, and (3) consideration of child's desires or opinions on receiving the vaccine. This study highlights specific factors influencing parent/guardian decisions on whether to vaccinate their children against SARS-CoV-2. The analysis also illustrates a potential role for children to play in influencing household vaccine decision-making.
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Affiliation(s)
| | | | - Laura Buback
- University of California, San Francisco, CA, USA
| | - Susie Welty
- University of California, San Francisco, CA, USA
| | | | | | - Wayne T A Enanoria
- University of California, San Francisco, CA, USA
- San Francisco Department of Public Health, San Francisco, CA, USA
| | - Mike Reid
- University of California, San Francisco, CA, USA
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Brown C, Morlock A, Blakolmer K, Heidari E, Morlock R. COVID-19 vaccination and race – A nationwide survey of vaccination status, intentions, and trust in the US general population. J Manag Care Spec Pharm 2022; 28:1429-1438. [PMID: 36427337 PMCID: PMC10372999 DOI: 10.18553/jmcp.2022.28.12.1429] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND: COVID-19 vaccine hesitancy for adults and children varies depending on societal factors, race, and trust ascribed to the source of vaccine information. OBJECTIVE: To assess COVID-19 vaccination rates and trust levels for vaccine information by race at 2 time points. METHODS: Online cross-sectional data from US adults were collected in February/March 2021 (T1) and November 2021 (T2). Questions included vaccination status, reasons for vaccine refusal, trust levels for vaccine information and the Wake Forest Physician Trust Scale. At T2, parents were asked about vaccination status of children aged 12-18 years and intent for children aged 5-11 years. Vaccination rates and trust levels for vaccine information were measured. Multivariable logistic regression was used to identify characteristics predictive of receiving COVID-19 vaccination. RESULTS: Vaccination rates were 20.2% and 70.8% at T1 and T2, respectively. At T1 and T2, higher proportions of White (23.2% and 72.0%) and Other race (14.4% and 75.2%) respondents were vaccinated relative to Black respondents (9.6% and 64.4%) (P < 0.05). In descending order, respondents' doctors, family members, and pharmacists were the most trusted information sources. Black parents, relative to White and Other parents with unvaccinated children aged 12-18 years or who were not very likely to vaccinate younger children, reported lowest physician trust (P < 0.01). At T1, being married, college educated, and older and having greater Wake Forest Physician Trust Scale scores and a higher number of comorbidities predicted a higher likelihood of being vaccinated. Being Black, having a median household income less than $100,000, and residing in the Northeast or Midwest, relative to the West, predicted a decreased likelihood of being vaccinated. At T2, race and comorbidities were no longer predictive of vaccination. CONCLUSIONS: Racial variation in vaccination status decreased from T1 to T2. Physician trust predicted vaccination status and intent regardless of race. Respondents' doctors, family members, and pharmacists are trusted sources of vaccine information, and targeting these influencers may reduce vaccination hesitancy. DISCLOSURES: Dr Brown reports personal fees from Taiho Oncology, outside the submitted work. Dr Morlock reports personal fees from Johnson and Johnson, Heron Therapeutics, Evofem Biosciences, Horizon Therapeutics, and Taiho Oncology, outside the submitted work. Amy Morlock reports personal fees from both AbbVie (formerly Allergan) and Ironwood, outside the submitted work. Drs Blakolmer and Heidari have nothing to disclose.
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Affiliation(s)
- Carolyn Brown
- Health Outcomes Division, College of Pharmacy, The University of Texas at Austin
| | - Amy Morlock
- Acumen Health Research Institute, Ann Arbor, MI
| | | | - Elham Heidari
- Health Outcomes Division, College of Pharmacy, The University of Texas at Austin
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Bonuck K, Iadarola S, Gao Q, Siegel JF. COVID-19 Vaccines for Children with Developmental Disabilities: Survey of New York State Parents' Willingness and Concerns. J Dev Behav Pediatr 2022; 43:521-528. [PMID: 36067424 PMCID: PMC9698114 DOI: 10.1097/dbp.0000000000001113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 06/10/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE While 1 in 6 US children have a developmental disability (DD), and such children are disproportionately affected by COVID-19, little is known about their vaccination status. We surveyed New York State parents of children with DDs to ascertain willingness and concerns regarding COVID-19 vaccines. METHODS An online survey was distributed to statewide DD networks from June to September 2021 (vaccines were authorized for adolescents in May 2021). We report associations between vaccine willingness and concerns and race/ethnicity, child age, in-person schooling, routine/flu vaccinations, and DD diagnoses. Willingness was categorized as "got/will get ASAP" (high), "wait and see/only if required," or "definitely not." RESULTS A total of 352 parents (49.1% White) responded. Willingness differed by age ( p < 0.001). High willingness was reported for 73.9%, 50.0%, and 36.0% of children aged 12 to 17, 6 to 11, and 0 to 5 years, respectively. Willingness differed by autism diagnosis ( p < 0.01) and routine and flu vaccination status ( p < 0.001). Predominant concerns included side effects (89%) and children with disabilities not being in trials (80%). Less common concerns were COVID not serious enough in children to warrant vaccine (23%) and misinformation (e.g., microchips, 5G, DNA changes) (24%). Concerns about vaccine safety differed by age ( p < 0.01) and were highest for older and then the youngest children. In age-stratified adjusted models, attention-deficit/hyperactivity disorder was negatively associated with high willingness for age 5 or younger (OR = 0.02, 95% confidence interval, <0.001-0.622). CONCLUSION Parents of children with DD in New York seemed highly willing for them to receive COVID-19 vaccines. Although few factors predicted willingness to vaccinate, addressing safety and developmental concerns regarding young children is warranted. Given their increased vulnerability, improved COVID-19 surveillance for children with DD is warranted.
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Affiliation(s)
- Karen Bonuck
- Departments of Family and Social Medicine, Division of Research and
- Pediatrics, Division of Developmental Medicine, Einstein College of Medicine, Montefiore Medical Center, Bronx, NY
| | - Suzannah Iadarola
- Department of Pediatrics, Division of Developmental and Behavioral Pediatrics, University of Rochester Medical Center, Rochester, NY
| | - Qi Gao
- Department of Epidemiology and Population Health, Einstein College of Medicine, Montefiore Medical Center, Bronx, NY
| | - Joanne F. Siegel
- Department of Pediatrics, Division of Developmental Medicine, Einstein College of Medicine, Montefiore Medical Center, Bronx, NY
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26
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Albanese A, Fallucchi F, Verheyden B. Can a supranational medicines agency restore trust after vaccine suspensions? The case of Vaxzevria. PLoS One 2022; 17:e0277554. [PMID: 36449501 DOI: 10.1371/journal.pone.0277554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 10/28/2022] [Indexed: 12/05/2022] Open
Abstract
Over the first half of March 2021, the majority of European governments suspended Astrazeneca's Vaxzevria vaccine as a precaution following media reports of rare blood clots. We analyse the impact of the European Medicines Agency's (EMA) March 18th statement assuring the public of the safety of Vaxzevria and the immediate reinstatement of the vaccine by most countries on respondents' intention to get vaccinated. By relying on survey data collected in Luxembourg and neighbouring areas between early March and mid-April, we observe that the willingness to be vaccinated was severely declining in the days preceding the EMA statement. We implement a regression discontinuity design exploiting the time at which respondents completed the survey and find that the vaccine reinstatement substantially restored vaccination intentions.
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Schiff J, Schmidt AR, Pham PK, Pérez JB, Pannaraj PS, Chaudhari PP, Liberman DB. Parental attitudes in the pediatric emergency department about the COVID-19 vaccine. Vaccine 2022; 40:7328-7334. [PMID: 36344362 PMCID: PMC9597585 DOI: 10.1016/j.vaccine.2022.10.046] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 10/11/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND COVID-19 vaccinations are now recommended in the United States (U.S.) for children ≥ 6 months old. However, pediatric vaccination rates remain low, particularly in the Hispanic/Latinx population. OBJECTIVE Using the 4C vaccine hesitancy framework (calculation, complacency, confidence, convenience), we examined parental attitudes in the emergency department (ED) towards COVID-19 vaccination, identified dimensions of parental vaccine hesitancy, and assessed parental willingness to have their child receive the COVID-19 vaccine. METHODS As part of a larger multi-methods study examining influenza vaccine hesitancy, we conducted interviews that included questions about COVID-19 vaccine authorization for children. We used directed content analysis to extract qualitative themes from 3 groups of parents in the ED: Hispanic/Latinx Spanish speaking (HS), Hispanic/Latinx English speaking (HE), non-Hispanic/non-Latinx White English speaking (WE). Themes were triangulated with the Parent Attitudes about Childhood Vaccines (PACV) survey, where higher scores indicate increased vaccine hesitancy. RESULTS Factors influencing vaccine hesitancy were mapped to the 4C framework from 58 sets of interviews and PACVs. HE and HS parents, compared to WE parents, had less knowledge about COVID-19 and its vaccine, and more beliefs in COVID-19 vaccine myths. However, both HS and HE parent groups were more inclined to endorse COVID-19 vaccine effectiveness as a reason to have their children vaccinated. HS parents felt that COVID-19 increased their fear of illnesses in general and were worried about confusing COVID-19 with other infections. Median PACV scores of HS (Mdn = 20) and HE (Mdn = 20) parent groups were higher than of WE parents (Mdn = 10), but parental willingness to have their child receive COVID-19 vaccination was similar across groups. CONCLUSIONS Higher COVID-19 vaccine hesitancy among HS and HE parents compared to WE parents may be attributed to insufficient knowledge about COVID-19, its vaccine, along with COVID-19 vaccine myths. Efforts to provide targeted vaccine education to different populations is warranted.
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Affiliation(s)
- Jared Schiff
- Division of Emergency and Transport Medicine, Children’s Hospital Los Angeles, Los Angeles, CA, USA,Corresponding author at: Division of Emergency and Transport Medicine, Children’s Hospital Los Angeles, 4650 Sunset Blvd. Mailstop #113, Los Angeles, CA, USA
| | - Anita R. Schmidt
- Division of Emergency and Transport Medicine, Children’s Hospital Los Angeles, Los Angeles, CA, USA
| | - Phung K. Pham
- Division of Emergency and Transport Medicine, Children’s Hospital Los Angeles, Los Angeles, CA, USA,Division of Behavioral and Organizational Sciences, Claremont Graduate University of the Claremont Colleges, Claremont, CA, USA
| | - Jocelyn B. Pérez
- Division of Emergency and Transport Medicine, Children’s Hospital Los Angeles, Los Angeles, CA, USA
| | - Pia S. Pannaraj
- Division of Infectious Disease, Children’s Hospital Los Angeles, Los Angeles, CA, USA,Department of Pediatrics and Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Pradip P. Chaudhari
- Division of Emergency and Transport Medicine, Children’s Hospital Los Angeles, Los Angeles, CA, USA,Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Danica B. Liberman
- Division of Emergency and Transport Medicine, Children’s Hospital Los Angeles, Los Angeles, CA, USA,Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA,Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Kaufmann J, DeVoe JE, Angier H, Moreno L, Cahen V, Marino M. Association of parent influenza vaccination and early childhood vaccinations using linked electronic health record data. Vaccine 2022; 40:7097-7107. [PMID: 36404427 PMCID: PMC10202113 DOI: 10.1016/j.vaccine.2022.09.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 09/08/2022] [Accepted: 09/12/2022] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Parent and child vaccination behavior is related for human papillomavirus (HPV) and flu vaccine. Thus, it is likely that parental vaccination status is also associated with their children's adherence to guideline-concordant childhood vaccination schedules. We hypothesized that parent influenza (flu) vaccination would be associated with their child's vaccination status at age two. METHODS We used electronic health record data to identify children and linked parents seen in a community health center (CHC) within the OCHIN network (292 CHCs in 16 states). We randomly selected a child aged <2 years with ≥1 ambulatory visit between 2009-2018. Employing a retrospective, cohort study design, we used general estimating equations logistic regression to estimate the odds of a child being up-to-date on vaccinations based on their linked parents' flu vaccination status. We adjusted for relevant parent and child covariates and stratified by mother only, father only, and two-parent samples. RESULTS The study included 40,007 family-units: mother only = 35,444, father only = 2,784, and two parents = 1,779. A higher percentage of children were fully vaccinated if their parent or parents received a flu vaccine. Children in the two-parent sample whose parents both received a flu vaccine had more than twice the odds of being fully vaccinated, and two and a half times the odds of being fully vaccinated except flu vaccine compared to children with two parents who did not receive a flu vaccine (covariate-adjusted odds ratio [aOR] = 2.39, 95% CI = 1.67, 3.43 and aOR = 2.54, 95% CI = 1.54, 4.19, respectively). CONCLUSIONS Parent flu vaccination is associated with routine child vaccination. Future research is needed to understand if this relationship persists over time and in different settings.
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Affiliation(s)
- Jorge Kaufmann
- Oregon Health & Science University, 3181 Sam Jackson Park Road, Portland, OR 97239, USA
| | - Jennifer E DeVoe
- Oregon Health & Science University, 3181 Sam Jackson Park Road, Portland, OR 97239, USA
| | - Heather Angier
- Oregon Health & Science University, 3181 Sam Jackson Park Road, Portland, OR 97239, USA
| | - Laura Moreno
- Oregon Health & Science University, 3181 Sam Jackson Park Road, Portland, OR 97239, USA.
| | - Viviane Cahen
- Oregon Health & Science University, 3181 Sam Jackson Park Road, Portland, OR 97239, USA
| | - Miguel Marino
- Oregon Health & Science University, 3181 Sam Jackson Park Road, Portland, OR 97239, USA
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29
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Panchalingam T, Shi Y. Parental refusal and hesitancy of vaccinating children against COVID-19: Findings from a nationally representative sample of parents in the U.S. Prev Med 2022; 164:107288. [PMID: 36228873 PMCID: PMC9549707 DOI: 10.1016/j.ypmed.2022.107288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 09/29/2022] [Accepted: 10/02/2022] [Indexed: 12/04/2022]
Abstract
The uptake rate of COVID-19 vaccines among children remains low in the U.S. This study aims to 1) identify sociodemographic and behavioral factors influencing parental refusal of vaccinating children, and 2) quantify the relative importance of vaccine characteristics in parental hesitancy of vaccinating children. An online survey was conducted from October to November 2021 among a probability-based, representative sample of 1456 parents with children under age 18. The survey included a discrete choice experiment asking parents to choose between two hypothetical COVID-19 vaccine alternatives with varying levels of characteristics in 10 hypothetical scenarios. Logistic regressions were used to estimate parental refusal (refused to choose any vaccine alternatives in all hypothetical scenarios) and random parameter logit regressions were used to estimate parental hesitancy (choice of vaccine alternatives depended on vaccine characteristics) of vaccinating children. About 20% parents refused to vaccinate children. The refusal is predicted by parents' sociodemographic characteristics, political orientation, vaccination status, and parents' and children's previous exposure with COVID-19. Among parents who were willing to consider vaccinating children, the most important vaccine characteristics are risk of severe side effects (31.2% relative importance) and effectiveness (30.7%), followed by protection duration (22.6%), local coverage (9.4%), and hospitalization rate of unvaccinated children (6.1%). Our findings imply that policymakers and public health professionals could develop outreach programs at community level to encourage specific subgroups and focus on vaccination depoliticization. Effectively communicating the low risk of severe side effects and high effectiveness of the vaccines may relieve some of the parental hesitancy.
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Affiliation(s)
- Thadchaigeni Panchalingam
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Yuyan Shi
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA.
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Srivastava T, Shen AK, Browne S, Michel JJ, Tan ASL, Kornides ML. Comparing COVID-19 Vaccination Outcomes with Parental Values, Beliefs, Attitudes, and Hesitancy Status, 2021-2022. Vaccines (Basel) 2022; 10:vaccines10101632. [PMID: 36298497 PMCID: PMC9611997 DOI: 10.3390/vaccines10101632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/20/2022] [Accepted: 09/26/2022] [Indexed: 11/16/2022] Open
Abstract
Despite the availability of safe and effective COVID-19 vaccines, vaccine acceptance has been low, particularly among parents. More information is needed on parental decision-making. We conducted a prospective cohort study from October 2021 to March 2022 among 334 parents in a large urban/suburban pediatric primary care network and linked longitudinal survey responses about attitudes and beliefs on vaccination, social norms, and access to vaccination services for COVID-19 to electronic health-record-derived vaccination outcomes for their eldest age-eligible children in June 2022. The odds of accepting two doses of COVID-19 vaccine for their child was higher in respondents who indicated the COVID-19 vaccine would be very safe (aOR [CI]: 2.69 [1.47−4.99], p = 0.001), as well as those who previously vaccinated their child against influenza (aOR [CI]: 4.07 [2.08−8.12], p < 0.001). The odds of vaccinating their child were lower for respondents who attended suburban vs. urban practices (aOR [CI]: 0.38 [0.21−0.67], p = 0.001). Parents in the cohort were active users of social media; the majority (78%) used their phone to check social media platforms at least once per day. Our findings suggest that healthcare providers and policymakers can focus on improving vaccination coverage among children living in suburban neighborhoods through targeted mobile-based messaging emphasizing safety to their parents.
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Affiliation(s)
- Tuhina Srivastava
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA 19104, USA
- Leonard David Institute for Health Economics, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Angela K. Shen
- Leonard David Institute for Health Economics, University of Pennsylvania, Philadelphia, PA 19104, USA
- Vaccine Education Center, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Medical Bioethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Correspondence: ; Tel.: +1-(301)-467-7770
| | - Safa Browne
- Vaccine Education Center, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Jeremy J. Michel
- General Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- ECRI Guidelines Trust, ECRI, Plymouth Meeting, Philadelphia, PA 19462, USA
| | - Andy S. L. Tan
- Leonard David Institute for Health Economics, University of Pennsylvania, Philadelphia, PA 19104, USA
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Melanie L. Kornides
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Leonard David Institute for Health Economics, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Pediatrics, Division of Adolescent Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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Goldman RD, Seiler M, Olson PG, Hart RJ, Bone JN, Baumer-Mouradian SH. Factors associated with unvaccinated caregivers who plan to vaccinate their children. Prev Med 2022; 162:107121. [PMID: 35863584 PMCID: PMC9290374 DOI: 10.1016/j.ypmed.2022.107121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/24/2022] [Accepted: 06/15/2022] [Indexed: 12/02/2022]
Abstract
Vaccine hesitancy is complex and a threat to global public health during the ongoing COVID-19 pandemic. Our objective was to determine factors associated with caregivers' willingness to vaccinate children despite not being immunized themselves against COVID-19. The International COVID-19 Parental Attitude Study (COVIPAS), a multinational cohort study, recruited caregivers of children 0-18 years old in 21 Emergency Departments (EDs) in USA, Canada, Israel, and Switzerland during November-December 2021. Of a total of 4536 caregivers who completed the survey, 882 (19.4%) were unvaccinated, and 62 (7.0%) of the unvaccinated planned to vaccinate their children. Unvaccinated caregivers with children that had their childhood vaccines up-to-date (OR 3.03 (1.36, 8.09), p = 0.01), and those very worried their child has COVID-19 in the ED (OR 3.11 (1.44, 6.34), p < 0.01) were much more likely to plan to immunize their children. Primary care providers and public health agencies should not assume that unvaccinated parents will not vaccinate their children. Determining child's vaccination status and parental level of concern about COVID-19 may help identify caregivers who are open to give their children the vaccine.
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Affiliation(s)
- R D Goldman
- The Pediatric Research in Emergency Therapeutics (PRETx) Program, Division of Emergency Medicine, Department of Pediatrics, University of British Columbia, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada.
| | - M Seiler
- Emergency Department, University Children's Hospital Zurich, Zurich, Switzerland.
| | - P G Olson
- Department of Pediatrics, Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, Los Angeles, CA, United States.
| | - R J Hart
- Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Louisville, Louisville, KY, United States.
| | - J N Bone
- Research Informatics, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada.
| | - S H Baumer-Mouradian
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, United States.
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Hammershaimb EA, Cole LD, Liang Y, Hendrich MA, Das D, Petrin R, Cataldi JR, O'Leary ST, Campbell JD. COVID-19 Vaccine Acceptance Among US Parents: A Nationally Representative Survey. J Pediatric Infect Dis Soc 2022; 11:361-370. [PMID: 35748047 PMCID: PMC9278238 DOI: 10.1093/jpids/piac049] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 05/31/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Little was known about US parental attitudes, beliefs, and intentions surrounding coronavirus disease 2019 (COVID-19) vaccines for children before their introduction. METHODS An online cross-sectional nationally representative survey of US parents/guardians of children < 18 years old via Ipsos KnowledgePanel, fielded from October 26, 2021 to November 30, 2021. RESULTS Response rate was 64.2% (3230/5034). For children ages 0-4 years, 51.5% of parents were likely to have their children vaccinated, and for ages 5-11 and 12-17, 54.0% and 69.7% of parents, respectively, reported they were likely to vaccinate or had already vaccinated their children. Among respondents with unvaccinated children, 25.2% (ages 0-4) and 22.0% (ages 5-11) reported they would seek COVID-19 vaccination for their children as soon as authorization occurred. Factors associated with willingness to have children receive a COVID-19 vaccine were: belief in benefits of COVID-19 vaccination (odds ratio [OR] = 6.44, 5.68, 4.57 in ages 0-4, 5-11, and 12-17 respectively), acceptance of routine childhood vaccines (OR = 6.42, 5.48, 1.76), parental COVID-19 vaccination (OR = 1.85, 3.70, 6.16), perceptions that pediatric COVID-19 is severe (OR = 1.89, 1.72, 1.35), Hispanic ethnicity (OR = 2.07, 2.29, 2.60), influenza vaccine acceptance (OR = 1.07, 0.88, 1.62), presence of children of another age group in the household (OR = 0.71, 0.71, 0.65), and attitudinal barriers to COVID-19 vaccination (OR = 0.30, 0.26, 0.49). CONCLUSIONS Belief in the benefits of COVID-19 vaccination and acceptance of routine childhood vaccines are the strongest predictors of intention to vaccinate children. Further research is needed to track how parental attitudes change as more data about pediatric COVID-19 vaccines become available and how intentions translate into pediatric vaccine uptake.
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Affiliation(s)
- E Adrianne Hammershaimb
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Lyndsey D Cole
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Yuanyuan Liang
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | | | - Dhiman Das
- Ipsos Public Affairs, Washington DC, USA
| | | | - Jessica R Cataldi
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus Aurora, Colorado, USA
- Children's Hospital Colorado, Aurora, Colorado, USA
| | - Sean T O'Leary
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus Aurora, Colorado, USA
- Children's Hospital Colorado, Aurora, Colorado, USA
| | - James D Campbell
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
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Hou Z, Song K, Wang Q, Zang S, Tu S, Chantler T, Larson HJ. Childhood COVID-19 vaccine acceptance and preference from caregivers and healthcare workers in China: A survey experiment. Prev Med 2022; 161:107138. [PMID: 35809825 PMCID: PMC9259187 DOI: 10.1016/j.ypmed.2022.107138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 06/14/2022] [Accepted: 07/02/2022] [Indexed: 11/28/2022]
Abstract
With approval of more COVID-19 vaccines for children, vaccine attributes may influence parental acceptance and choices. We aimed to assess effects of vaccine attributes and information on herd immunity on childhood COVID-19 vaccine acceptance. A survey experiment was conducted with caregivers of children aged 6 months to 11 years old and health care workers (HCWs) in China from September 14 to November 18, 2021. Respondents were randomly assigned to receive differing information on herd immunity (> 80% of the entire population must be vaccinated; or no information). Respondents then completed eight discrete choice tasks to assess vaccine acceptance based on attributes. 2331 (90.07%) of 2588 surveyed caregivers and 1576 (92.71%) of 1700 surveyed HCWs would accept COVID-19 vaccination for children, respectively. High Odds Ratios (OR) were found for acceptance of a vaccine with 90% over 50% efficacy (OR 6.70 [95% CI 6.11-7.35] for caregivers; 11.44 [10.12-12.95] for HCWs); and risk of adverse reactions to be 1 over 10 in 10,000 (3.96 [3.72-4.22] for caregivers; 2.98 [2.76-3.22] for HCWs). To achieve herd immunity target (> 80% vaccination coverage), vaccine efficacy should reach over 70% and risk of adverse reactions lower than 1 in 10,000. Knowledge on herd immunity target increased the odds of vaccine acceptance (1.82 [1.34-2.46] for caregivers; 2.42 [1.58-3.72] for HCWs). Childhood COVID-19 vaccine acceptance was high in China, independent of child's age, and depended on vaccine attributes.
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Affiliation(s)
- Zhiyuan Hou
- School of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China.
| | - Kuimeng Song
- School of Health Care Security, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Qian Wang
- School of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Shujie Zang
- School of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Shiyi Tu
- School of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Tracey Chantler
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, UK
| | - Heidi J Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, UK; Department of Health Metrics Sciences, University of Washington, Seattle, USA
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Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in children generally have milder presentations, but severe disease can occur in all ages. MIS-C and persistent post-acute COVID-19 symptoms can be experienced by children with previous infection and emphasize the need for infection prevention. Optimal treatment for COVID-19 is not known, and clinical trials should include children to guide therapy. Vaccines are the best tool at preventing infection and severe outcomes of COVID-19. Children suffered disproportionately during the pandemic not only from SARS-CoV-2 infection but because of disruptions to daily life, access to primary care, and worsening income inequalities.
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Affiliation(s)
- Eric J. Chow
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, 1959 NE Pacific Street, Box 356423, Seattle, WA 98195, USA,Corresponding author.
| | - Janet A. Englund
- Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Washington, Seattle Children’s Research Institute, 4800 Sand Point Way NE - MA7.234, Seattle, WA 98105, USA
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Nguyen KH, Nguyen K, Mansfield K, Allen JD, Corlin L. Child and adolescent COVID-19 vaccination status and reasons for non-vaccination by parental vaccination status. Public Health 2022. [PMID: 35870290 PMCID: PMC9189141 DOI: 10.1016/j.puhe.2022.06.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/18/2022] [Accepted: 06/05/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVES COVID-19 vaccines are recommended for children ages ≥5 years. To develop effective interventions to increase uptake, this study explores reasons for parental hesitancy of child and adolescent COVID-19 vaccination. STUDY DESIGN The Household Pulse Survey (HPS) is a nationally representative cross-sectional online household survey of adults aged ≥18 years that began data collection in April 2020 to help understand household experiences during the COVID-19 pandemic. METHODS Using data from December 29, 2021, to January 10, 2022 (n = 11,478), we assessed child and adolescent COVID-19 vaccination coverage and parental intent to vaccinate their children and adolescents. Factors associated with child and adolescent vaccination coverage were examined using multivariable regression models. Reasons for not having had their child or adolescent vaccinated, stratified by parental vaccination status, were compared using tests of differences in proportions. RESULTS Less than one-half (42.3%) of children and three-quarters (74.8%) of adolescents are vaccinated. Vaccination coverage was lower among households with lower education, as well as among children who had not had a preventive check-up in the past year. Parents of unvaccinated children were more likely to report that they do not trust COVID-19 vaccines, do not trust the government, and do not believe children need a COVID-19 vaccine compared to parents of vaccinated children. CONCLUSION Efforts to increase uptake of vaccines by children and adolescents should target those with lower education, reassure parents of the vaccine safety and efficacy for themselves and their children/adolescents, and support yearly preventive care visits for their children.
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Willis DE, Schootman M, Shah SK, Reece S, Selig JP, Andersen JA, McElfish PA. Parent/guardian intentions to vaccinate children against COVID-19 in the United States. Hum Vaccin Immunother 2022; 18:2071078. [PMID: 35506876 PMCID: PMC9302502 DOI: 10.1080/21645515.2022.2071078] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Vaccination is critical for protecting adults and children from COVID-19 infection, hospitalization, and death. Analyzing subsamples of parent/guardians of children age 0–11 (n = 343) and 12–17 (n = 322) from a larger national survey of US adults (n = 2,022), we aimed to assess intentions to vaccinate children and how intentions might vary across parent/guardian sociodemographic characteristics, healthcare coverage, vaccination status, political affiliation, prior COVID-19 infection, exposure to COVID-19 death(s) of family or friends, perceived norms of vaccination, and COVID-19 vaccine hesitancy. We also report the prevalence of vaccinated children for parents whose oldest child was eligible for vaccination at the time of the survey. More than one third of parents whose oldest child was not yet eligible for vaccination (11 or younger) planned to get them vaccinated right away when a vaccine became available to them. Among parents whose child was eligible to be vaccinated (age 12–17 years), approximately a third reported their child had already been vaccinated and approximately a third planned to do so right away. Intentions to vaccinate children age 0 to 11 were significantly associated with age, gender, race/ethnicity, education, COVID-19 vaccination, political affiliation, social norms, and COVID-19 vaccine hesitancy. Intentions to vaccinate children age 12 to 17 were significantly associated with age, education, healthcare coverage, COVID-19 vaccination, political affiliation, social norms, and COVID-19 vaccine hesitancy. We discuss implications for public health officials and for future research.
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Affiliation(s)
- Don E Willis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Mario Schootman
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Sumit K Shah
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Sharon Reece
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - James P Selig
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Jennifer A Andersen
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
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Alsulaiman JW, Mazin M, Al-Shatanawi TN, Kheirallah KA, Allouh MZ. Parental Willingness to Vaccinate Their Children Against SARS-CoV-2 in Jordan: An Explanatory Cross-Sectional Study. Risk Manag Healthc Policy 2022; 15:955-967. [PMID: 35585873 PMCID: PMC9109983 DOI: 10.2147/rmhp.s360838] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 05/04/2022] [Indexed: 11/23/2022] Open
Abstract
Background Successful control of the COVID-19 pandemic is largely dependent on vaccine administration to epidemiologically influential groups, including children. Considering that pediatric population comprises a significant portion on the population in developing countries, and their risk of infection and spreading the disease has been underestimated, it is crucial to investigate parental willingness to administer SARS-CoV-2 vaccine to their children between 5 and 11 years old. This study investigates the prevalence and determinants of parental willingness towards vaccinating their children (5–12 years old) against COVID-19 in a developing country setting, Jordan. Methods A cross-sectional study, conducted between October and November 2021, utilized online Google Forms to collect data on parents’ background characteristics, willingness to vaccinate their children, SARS-CoV-2, infection and vaccine, risk perception, and factors affecting decision to vaccinate. Results A total of 564 parents completed the questionnaire; 82.8% were mothers, 85.3% were 30 years of age or older, and 75.9% had bachelor’s degrees or higher. Only 25.4% of parents reported willingness to vaccinate their 5–12 years old children against SARS-CoV-2. Lower parental age, higher income, and having health insurance coverage increased parental willingness. Among participants vaccinated against COVID-19, only 29.0% were willing to vaccinate their children. Healthcare providers’ trust and vaccine recommendations by pediatricians increased parental willingness. COVID-19 risk perception seems to have negative effects on parental willingness. Conclusion A significant proportion of parents in Jordan indicated hesitancy towards administering COVID-19 vaccine for their children. Concerns about vaccine safety and trust in the healthcare system appear to be the most important predictors of parents’ hesitancy. Effective vaccine campaigns should focus on risk perception and communication and should consider parental socio-demographic characteristics.
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Affiliation(s)
- Jomana W Alsulaiman
- Department of Pediatrics, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Mai Mazin
- Department of Pediatrics, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Tariq N Al-Shatanawi
- Department of Public Health, Faculty of Medicine, Al-Balqa Applied University, Salt, Jordan
| | - Khalid A Kheirallah
- Department of Public Health and Community Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammed Z Allouh
- Department of Anatomy, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Correspondence: Mohammed Z Allouh, Department of Anatomy, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, 15551, United Arab Emirates, Tel +971 3713 7551, Email
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Kheil MH, Jain D, Jomaa J, Askar B, Alcodray Y, Wahbi S, Brikho S, Kadouh A, Harajli D, Jawad ZN, Fehmi Z, Elhage M, Tawil T, Fehmi O, Alzouhayli SJ, Ujayli D, Suleiman N, Kazziha O, Saleh R, Abada E, Shallal A, Kim S, Kumar VA, Zervos M, Cote ML, Ali-Fehmi R. COVID-19 Vaccine Hesitancy among Arab Americans. Vaccines (Basel) 2022; 10:610. [PMID: 35455359 DOI: 10.3390/vaccines10040610] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Coronavirus disease-2019 (COVID-19) vaccines have a significant impact on reducing morbidity and mortality from infection. However, vaccine hesitancy remains an obstacle in combating the pandemic. The Arab American (AA) population is understudied; thus, we aimed to explore COVID-19 attitudes within this community. (2) Methods: This was a cross-sectional study. An anonymous online survey was distributed to members of different AA associations and to the community through the snowball method. (3) Results: A total of 1746 participants completed the survey. A total of 92% of respondents reported having received at least one dose of a COVID-19 vaccine. A total of 73% reported willingness to receive a booster, and 72% plan to give their children the vaccine. On multivariate analysis, respondents were more likely to be vaccine-hesitant if they were hesitant about receiving any vaccine in general. They were less likely to be vaccine-hesitant if they were immigrants, over the age of 40, up to date on their general vaccination and if they believed that COVID-19 vaccines are safe and effective in preventing an infection. The belief that all vaccines are effective at preventing diseases was also associated with lower hesitancy. (4) Conclusions: This sample of AAs have higher vaccination rates and are more willing to vaccinate their children against COVID-19 when compared to the rest of the population. However, a reemergence of hesitancy might be arising towards the boosters.
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Murthy NC, Zell E, Fast HE, Murthy BP, Meng L, Saelee R, Vogt T, Chatham-Stephens K, Ottis C, Shaw L, Gibbs-Scharf L, Harris L, Chorba T. Disparities in First Dose COVID-19 Vaccination Coverage among Children 5-11 Years of Age, United States. Emerg Infect Dis 2022; 28:986-989. [PMID: 35226801 PMCID: PMC9045440 DOI: 10.3201/eid2805.220166] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
We analyzed first-dose coronavirus disease vaccination coverage among US children 5–11 years of age during November–December 2021. Pediatric vaccination coverage varied widely by jurisdiction, age group, and race/ethnicity, and lagged behind vaccination coverage for adolescents aged 12–15 years during the first 2 months of vaccine rollout.
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40
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McElfish PA, Willis DE, Shah SK, Reece S, Andersen JA, Schootman M, Richard-Davis G, Selig JP, Warmack TS. Parents' and Guardians' Intentions to Vaccinate Children against COVID-19. Vaccines (Basel) 2022; 10. [PMID: 35334993 DOI: 10.3390/vaccines10030361] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/16/2022] [Accepted: 02/23/2022] [Indexed: 01/12/2023] Open
Abstract
A cross-sectional survey design was used to assess Arkansas parents'/guardians' intentions to vaccinate their child against COVID-19. Parents/guardians whose oldest child was age 0-11 years (n = 171) or 12-17 years (n = 198) were recruited between 12 July and 30 July 2021 through random digit dialing. Among parents/guardians with an age-eligible child, age 12-17, 19% reported their child had been vaccinated, and 34% reported they would have their child vaccinated right away. Among parents/guardians with a child aged 0-11, 33% of parents/guardians reported they would have their child vaccinated right away. Twenty-eight percent (28%) of parents/guardians whose oldest child was 12-17 and 26% of parents/guardians whose oldest child was 0-11 reported they would only have their child vaccinated if their school required it; otherwise, they would definitely not vaccinate them. For both groups, parents'/guardians' education, COVID-19 vaccination status, and COVID-19 vaccine hesitancy were significantly associated with intentions to vaccinate their child. More than a third of parents/guardians whose child was eligible for vaccination at the time of the survey reported they intended to have them vaccinated right away; however, they had not vaccinated their child more than two months after approval. This finding raises questions about the remaining barriers constraining some parents/guardians from vaccinating their child.
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Low JM, Soo CWT, Phuong TA, Zhong Y, Lee LY. Predicting vaccine hesitancy among parents towards COVID-19 vaccination for their children in Singapore. Front Pediatr 2022; 10:994675. [PMID: 36299688 PMCID: PMC9589407 DOI: 10.3389/fped.2022.994675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There was a considerably slower uptake among children despite the high COVID-19 vaccination uptake amongst adults and adolescents in Singapore. This was concerning as unvaccinated children are at risk of severe COVID-19 infections and a source and reservoir of infections. We sought to understand the impact of social media on parental vaccine hesitancy and to determine the risk factors associated with vaccine hesitancy. METHODS An electronic survey conducted from November 2021 to March 2022. Data on the demographic profiles of respondents and to classify them based on their vaccine hesitancy status. Data including the choice of social media used to obtain information on the COVID-19 pandemic, frequency of use were collected. Statistical significance was defined as p < 0.05. RESULTS Six hundred and twenty-eight parents participated. 66.9% of parents were not vaccine hesitant. About a third (27.2%) considered themselves somewhat vaccine hesitant. Fathers were more vaccine hesitant than mothers. Vaccine hesitancy was also associated with having a lower household income, unvaccinated parents, knowing someone with an adverse reaction to the Covid 19 vaccine and having a low level of trust in their child's doctor. There was no significant difference with high usage of social media between parents who were not vaccine hesitant vs. those who were vaccine hesitant. Despite high usage of social media, about two thirds (62.7%) of parents preferred print material to obtain COVID-19 related information. Parental trust in their child's doctor was the most significant factor in determining vaccine hesitancy amongst parents. When the variables of gender, household income status, vaccine status were further analysed with a multinomial logistic regression model, vaccine hesitancy in a parent could be predicted with a 70% accuracy, and non-vaccine hesitancy with a 92.4% accuracy. CONCLUSION Newspapers and print media were the primary sources used in obtaining information on COVID-19 vaccine safety and efficacy, especially amongst parents with a higher household income. Healthcare providers should continue to establish rapport amongst parents, in particular the group with a lower household income to encourage higher paediatric COVID-19 vaccine uptake as well as correct COVID-19 related vaccine misconceptions or vaccine hesitancy, if present.
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Affiliation(s)
- Jia Ming Low
- Department of Neonatology, Khoo Teck Puat - National University Children's Medical Institute, National University Health System, Singapore, Singapore
| | - Chloe Wen Ting Soo
- Department of Neonatology, Khoo Teck Puat - National University Children's Medical Institute, National University Health System, Singapore, Singapore
| | - T A Phuong
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Youjia Zhong
- Department of Neonatology, Khoo Teck Puat - National University Children's Medical Institute, National University Health System, Singapore, Singapore.,Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Le Ye Lee
- Department of Neonatology, Khoo Teck Puat - National University Children's Medical Institute, National University Health System, Singapore, Singapore.,Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Hoshen M, Shkalim Zemer V, Ashkenazi S, Grossman Z, Gerstein M, Yosef N, Cohen M, Cohen HA. How to increase COVID-19 vaccine uptake among children? determinants associated with vaccine compliance. Front Pediatr 2022; 10:1038308. [PMID: 36714648 PMCID: PMC9880470 DOI: 10.3389/fped.2022.1038308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 12/30/2022] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE Three aims: to elucidate determinants associated with COVID-19 vaccine uptake in children and the association with parental vaccination; to compare rates of PCR-positive SARS-CoV-2 results between vaccinated and unvaccinated children; to estimate the rate of parental COVID-19 vaccination and its association with the vaccination rate of their children. METHODS We performed a retrospective chart review of all children aged 5-11 years registered at a central district in Israel from November 21st, 2021 to April 30th, 2022, and characterized COVID-19 vaccinated vs. unvaccinated individuals. Data retrieved from the electronic medical files included: demographics [age, gender, sector, socioeconomic status (SES)]; COVID-19 vaccination (first and second doses) and influenza vaccination status; co-morbidities; and parental vaccinations for COVID-19. We divided the population into three distinct demographic groups: non-ultra-orthodox Jews (43,889 children), ultra-orthodox Jews (13,858 children), and Arabs (4,029 children). RESULTS Of the 61,776 children included in the study, 20,355 (32.9%) received at least one dose of the COVID-19 vaccine. Vaccination rates were similar amongst males and females and were higher in children aged 9-11 years compared to children aged 5-6 years. Multivariate analysis identified five independent determinants that were significantly (p < 0.001) associated with low vaccination rates: Arab and ultra-orthodox sectors (odds ratios: 0.235 and 0.617, respectively); children aged 5-8 years; children of low SES; and children who had not received previous seasonal influenza vaccination. Relatively high vaccination rates were noted amongst children with the following medical co-morbidities: treatment with biological agents (42.9%); solid tumor transplantation (42.9%); type 1 diabetes mellitus (38.5%), asthma (38.2%), and attention deficit and hyperactivity disorder (ADHD) (37.6%). Regarding the uptake of two vaccine doses among children with co-morbidities, it was highest in those with type 1 diabetes mellitus, heart failure, treatment with biological agents, asthma and obesity. CONCLUSION This study highlights several pediatric sub-populations with low and high vaccine uptake. It is essential to focus on determinants associated with low vaccination rates.
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Affiliation(s)
- Moshe Hoshen
- Dan-Petach Tikva District, Clalit Health Services, Petach Tikva, Israel.,Bioinformatics Department, Jerusalem College of Technology, Jerusalem, Israel
| | - Vered Shkalim Zemer
- Dan-Petach Tikva District, Clalit Health Services, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Shai Ashkenazi
- Adelson School of Medicine, Ariel University, Ariel, Israel
| | - Zachi Grossman
- Adelson School of Medicine, Ariel University, Ariel, Israel.,Maccabi Healthcare Services, Tel Aviv, Israel
| | - Maya Gerstein
- Adelson School of Medicine, Ariel University, Ariel, Israel.,Pediatric Ambulatory Community Clinic, Petach Tikva, Israel
| | - Noga Yosef
- Dan-Petach Tikva District, Clalit Health Services, Petach Tikva, Israel
| | - Moriya Cohen
- Microbiology Unit, Ariel University, Ariel, Israel
| | - Herman Avner Cohen
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.,Pediatric Ambulatory Community Clinic, Petach Tikva, Israel
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