Covid-19 vaccine hesitancy and resistance amongst parents of children under 18 years of age in Ireland

COVID-19 vaccination refusal among the anti-vaccinationists in a Chinese society: a critical medical anthropology study of the vaccination barriers

Introduction

This study investigated the reasons for COVID-19 vaccination refusal among some Hong Kong residents who were anti-vaccinationists, despite the implementation of a vaccine incentive policy called the Vaccine Pass. The health belief model and the theory of planned behavior have been widely employed to analyze the determinants of COVID-19 vaccination. However, these two theories focus on the micro individual factors, which do not provide a sufficiently comprehensive analysis.

Study design

A qualitative descriptive approach with a critical medical anthropology framework.

Methods

This study adopts a critical medical anthropology framework that provides a micro and macro analysis at four social levels. A qualitative approach with individual, semi-structured, in-depth interviews was conducted from September 2022 to March 2023 with 30 individuals aged 20-59 years who did not receive COVID-19 vaccination in Hong Kong. The participants were recruited through purposive sampling and snowball sampling. A thematic analysis of data was implemented.

Results

The reasons for COVID-19 vaccination refusal involved intertwining relationships among factors in the four social levels of the critical medical anthropology framework. The participants' doubts about the safety of COVID-19 vaccines at the individual level were interacting with: (1) their ethnocultural beliefs and the perceived profit-oriented nature of vaccine production and distribution at the macro-social level, (2) their interpretation of the inconsistent advice of medical doctors at the micro-social level, and (3) their distrust in the government's vaccination policies at the intermediate-social level.

Conclusion

The participants' refusal of COVID-19 vaccines was correlated with perceived profit motives related to the vaccine, perceived conflict of interest of health-care providers, and the distrust of government.

Impact of COVID-19 pandemic on influenza vaccination rate among health care workers

Vaccinations against influenza are critical in mitigating the severity of the disease, preventing its transmission, and restricting its dissemination. Concerns about vaccination hesitancy among healthcare workers (HCWs) have been duly recognized during and following the COVID-19 pandemic. To examine the extent to which the COVID-19 pandemic has influenced the adoption of vaccinations among HCWs. A cross-sectional online survey was conducted four years after the COVID-19 pandemic among HCWs in Saudi Arabia. We performed a logistic regression analysis using influenza vaccination uptake as the dependent variable and perceived COVID-19 pandemic's impact, age, gender, marital status, employment status, education level, monthly income, respondent's overall health, doctor visits, tobacco use, number of adults in the household, and number of children in the household as independent variables. The study included 574 participants, an 86% response rate. Of the sample, 47% reported they had the influenza vaccination. HCWs who reported a greater negative impact due to the COVID-19 pandemic were 40% more likely to acquire the influenza vaccine (OR = 1.4, 95% CI [1.24, 1.58]). Compared to HCWs without children, HCWs with a child had a 44% lower likelihood of taking the influenza vaccination (OR = 0.34, 95% CI [0.16, 0.69]). The odds of HCWs obtaining the influenza vaccine were 4.5 times higher for those who reported one yearly medical visit, 2.6 times higher for two, and 1.4 times higher for three or more. HCWs who experienced more severe COVID-19 outcomes were more likely to get vaccinated against the virus. However, long-term monitoring of this inclination is necessary.

The Impact of COVID-19 on DTP3 Vaccination Coverage in Europe (2012-2023)

BACKGROUND

The COVID-19 pandemic disrupted routine child immunization efforts, threatening to reverse progress in controlling vaccine-preventable diseases.

MATERIALS AND METHODS

We analyzed the impact of COVID-19 on DTP3 vaccination in Europe by comparing trends before and after the pandemic using time series data from 2000 to 2023. Employing joinpoint regression, chi-square tests, and segmented regression analysis, we assessed DTP3 vaccination trends and coverage changes.

RESULTS

The findings revealed significant regional disparities across Europe. Statistical models indicated reductions in DTP3 coverage in countries such as Ireland, Sweden, and Switzerland, whereas Ukraine and San Marino showed improvements.

CONCLUSIONS

There are variations in the effect of COVID-19 on DTP3 coverage rates, indicating the need for targeted public health strategies to address vaccine hesitancy, logistical barriers, and systemic inequities.

Concordance, motivations and associated factors of COVID-19 vaccination among parent-child dyads: a cross-sectional study in Caraga Region, the Philippines

BACKGROUND

COVID-19 vaccination rates remain low for children aged 11 and below, and understanding the extent to which parental decisions impact their children's vaccination status remains a challenge. This study aimed to explore the concordance and motivations for vaccination among parent-child dyads and determine the associated factors influencing their children's vaccination status.

DESIGN

A cross-sectional study was conducted from 1 March 2023 to 30 March 2023, recruiting parents from six representative primary schools across Butuan City, the Philippines. Pilot-tested, self-administered questionnaires were used during the face-to-face surveys with parent participants. To determine the associated factors of parental decisions to vaccinate their children, mixed-effects logistic regression was used, with school districts as a random effect.

PARTICIPANTS

A total of 593 participating parents were included in the study, with the majority being females (n=484, 81.6%) and underserved, characterised by lacking a college degree (n=305, 51.4%) and having low to no income (n=511, 86.1%).

RESULTS

While 80.6% (n=478) of parents reported being vaccinated against COVID-19, only 36.2% (n=215) of them chose to vaccinate their children. A significant number of parents (n=285, 48.1%) reported psychological distress, with higher levels of distress prevalent among those who are indigenous, reside in rural areas and have lower income levels. Parental education and vaccination status emerged as influential factors. Specifically, parents with advanced degrees were 48% less likely to have unvaccinated children (adj OR (AOR)=0.52; 95% CI 0.30, 0.87), while unvaccinated parents had a sixfold increase in the likelihood of having unvaccinated children (AOR 6.1; 95% CI 3.14, 12.02) compared with their counterparts.

CONCLUSIONS

Efforts to increase paediatric vaccination rates should focus more on actively engaging parents, educating them about the vaccine's benefits and necessity, rather than solely relying on mandates to improve paediatric vaccination rates. Further research is needed to understand the reluctance of unvaccinated parents to vaccinate themselves and their children against COVID-19, identifying specific facilitators and barriers to develop more effective communication strategies and bolster vaccine acceptance.

Child COVID-19 vaccine uptake among participants of the 2015 Pelotas (Brazil) Birth Cohort Study

OBJECTIVE

To analyze COVID-19 vaccine uptake in children and to investigate factors associated with two outcomes variables: (a) not even beginning; (b) not completing the COVID-19 vaccine series.

METHODS

We used data of children aged 6-7 years from the 2015 Pelotas c Birth Cohort Study. COVID-19 vaccination status was collected from immunization cards and National Immunization Program Information System. Adjusted analyses were performed using a hierarchical model to identify factors associated with the two study outcomes.

RESULTS

Among 3867 children, 20.7 % (95 % CI, 19.5 %-22.0 %) did not even begin the 2-dose primary COVID-19 vaccine series, and 28.2 % (95 % CI, 26.6 %-29.8 %) did not complete the series with the second dose. Children not even beginning the COVID-19 vaccine series were more likely to have a White mother, not to have obesity, to have a history of COVID-19 infection, to have received non-recommended drugs for COVID-19, to be afraid of needles, and to have an incomplete diphtheria-tetanus-pertussis (DTP) and poliovirus immunization schedule. Not completing the 2-dose series was associated with lower maternal age and education, mother's self-identification as White or Brown, lower household income, lack of access to health services, not having completed the DTP and poliovirus immunization schedule and living with a person with a history of infection with COVID-19.

CONCLUSION

The results highlight a vaccine-hesitant parents' group who chose not beginning the COVID-19 vaccine series of their children and, another group of parents who failure to complete the child's series due to difficulty accessing health services.

Safety outcomes following COVID-19 vaccination and infection in 5.1 million children in England

The risk-benefit profile of COVID-19 vaccination in children remains uncertain. A self-controlled case-series study was conducted using linked data of 5.1 million children in England to compare risks of hospitalisation from vaccine safety outcomes after COVID-19 vaccination and infection. In 5-11-year-olds, we found no increased risks of adverse events 1-42 days following vaccination with BNT162b2, mRNA-1273 or ChAdOX1. In 12-17-year-olds, we estimated 3 (95%CI 0-5) and 5 (95%CI 3-6) additional cases of myocarditis per million following a first and second dose with BNT162b2, respectively. An additional 12 (95%CI 0-23) hospitalisations with epilepsy and 4 (95%CI 0-6) with demyelinating disease (in females only, mainly optic neuritis) were estimated per million following a second dose with BNT162b2. SARS-CoV-2 infection was associated with increased risks of hospitalisation from seven outcomes including multisystem inflammatory syndrome and myocarditis, but these risks were largely absent in those vaccinated prior to infection. We report a favourable safety profile of COVID-19 vaccination in under-18s.

Uptake of COVID-19 vaccinations amongst 3,433,483 children and young people: meta-analysis of UK prospective cohorts

SARS-CoV-2 infection in children and young people (CYP) can lead to life-threatening COVID-19, transmission within households and schools, and the development of long COVID. Using linked health and administrative data, we investigated vaccine uptake among 3,433,483 CYP aged 5-17 years across all UK nations between 4th August 2021 and 31st May 2022. We constructed national cohorts and undertook multi-state modelling and meta-analysis to identify associations between demographic variables and vaccine uptake. We found that uptake of the first COVID-19 vaccine among CYP was low across all four nations compared to other age groups and diminished with subsequent doses. Age and vaccination status of adults living in the same household were identified as important risk factors associated with vaccine uptake in CYP. For example, 5-11 year-olds were less likely to receive their first vaccine compared to 16-17 year-olds (adjusted Hazard Ratio [aHR]: 0.10 (95%CI: 0.06-0.19)), and CYP in unvaccinated households were less likely to receive their first vaccine compared to CYP in partially vaccinated households (aHR: 0.19, 95%CI 0.13-0.29).

Why did Brazil fail to vaccinate children against COVID-19 during the pandemic? An assessment of attitudinal and behavioral determinants

The objective of this study is to identify the determining attitudinal, behavioral, and sociodemographic factors behind the vaccination decision of parents and guardians in Brazil regarding immunization of children against COVID-19. Our data is obtained from a national online survey of 1,872 parents or guardians of children between 5 and 11 years of age, conducted from May 16 to 25, 2022. Our results show that, in Brazil, the decision to vaccinate children against COVID-19 is better explained by attitudinal and behavioral factors than sociodemographic ones. More precisely, the choice to immunize children against COVID-19 is strongly associated with the parents or guardians' own COVID-19 vaccination status, their ambivalence regarding this decision, their political preferences, and media use. In particular, parents and guardians who did not vaccinate against SARSCov2 and who supported former president Jair Bolsonaro (the main anti-vaccine political leader in the country during the COVID-19 pandemic) were substantially less likely to vaccinate their children. Parents and guardians with greater exposure to the country's major TV news program (Jornal Nacional/TV Globo), however, were more likely to do so. Other findings show that evangelicals - whose religious leaders strongly supported the former president -, young parents and guardians, and those from lower economic status were also less likely to vaccinate their children.

Analysis of the COVID-19 vaccine willingness and hesitancy among parents of healthy children aged 6 months-4 years: a cross-sectional survey in Italy

Introduction

In Italy, since December 2022, the COVID-19 vaccination has been extended to children aged 6 months-4 years with conditions of fragility and to those healthy at the request of the parent. The purposes of the cross-sectional survey were to determine the willingness and hesitancy of the parents/guardians to have their healthy children vaccinated against COVID-19.

Methods

The survey was performed among 389 parents/guardians with a child aged 6 months-4 years randomly selected from seven kindergartens and eight nursery schools in the geographic area of Naples, Italy.

Results

Only 10.5% were very concerned about the risk of infection, and the mean values regarding the perceived utility and safety of the COVID-19 vaccine were 3.3 and 3.2, respectively. Only 13.7% of participants were willing to consent to vaccinate the selected child against COVID-19, while 20.1% were uncertain and 66.2% did not intend. Parents/guardians of older children, those who received information about the COVID-19 vaccine from physicians or pediatricians, those who believed that the COVID-19 vaccine was useful, and those with lower hesitancy regarding the COVID-19 vaccine were more willing to vaccinate their child. The mean Parent Attitudes About Childhood Vaccines (PACV-5) score was 5.6, with 33.1% of respondents who were identified as highly hesitant toward COVID-19 vaccination (score ≥ 7). Parents/guardians with a lower perceived safety of the COVID-19 vaccine were more likely to be highly hesitant.

Discussion

The findings reveal the need to improve community-based education campaigns and effective promotion of the COVID-19 vaccination to increase willingness and address parental safety concerns.

Parent-Child Vaccination Concordance and Its Relationship to Child Age, Parent Age and Education, and Perceived Social Norms

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.

COVID-19 vaccination rates among adolescents (12-17 years) by immigrant background and sociodemographic factors: A nationwide registry study in Norway

PURPOSE

Lower COVID-19 vaccination rates have been observed among some adult immigrant populations in Norway, and there appears to be an association with sociodemographic factors. However, knowledge is lacking on the distribution of vaccination rates and role of sociodemographic factors among adolescents. This study aims to describe COVID-19 vaccination rates among adolescents according to immigrant background, household income, and parental education.

METHODS

In this nationwide registry study, we analyzed individual-level data on adolescents (12-17 years) from the Norwegian Emergency preparedness register for COVID-19 until September 15th, 2022. We estimated incidence rate ratios (IRR) for receiving at least one COVID-19 vaccine dose by country background, household income and parental education, using Poisson regression, adjusting for age, sex, and county.

RESULTS

The sample comprised 384,815 adolescents. Foreign-born and Norwegian-born with foreign-born parents, had lower vaccination rates (57 % and 58 %) compared to adolescents with at least one Norwegian-born parent (84 %). Vaccination rates by country background varied from 88 % (Vietnam) to 31 % (Russia). Variation and associations by country background, household income, and parental education were greater among 12-15-year-olds than 16-17-year-olds. Household income and parental education were positively associated with vaccination. Compared to the lowest income and education category, IRRs for household income ranged from 1.07 (95 % CI 1.06-1.09) to 1.31 (95 % CI 1.29-1.33) among 12-15-year-olds, and 1.06 (95 % CI 1.04-1.07) to 1.17 (95 % CI 1.15-1.18) among 16-17-year-olds. For parental education, from IRR 1.08 (95 % CI 1.06-1.09) to 1.18 (95 % CI 1.17-1.20) among 12-15-year-olds, and 1.05 (95 % CI 1.04-1.07) to 1.09 (95 % CI 1.07-1.10) among 16-17-year-olds.

CONCLUSION

COVID-19 vaccination rates varied by immigrant background and age group, with lower rates especially among adolescents with background from Eastern Europe and among younger adolescents. Household income and parental education were positively associated with vaccination rates. Our results may help target measures to increase vaccination rates among adolescents.