ABSTRACT
Background. Vaccine hesitancy (VH) is adversely affecting the public health response to the COVID-19 pandemic. Similarly, influenza vaccine uptake is suboptimal. We aimed to monitor trends in VH with respect to influenza, SARS-CoV-2, and routine childhood vaccines. Methods. We conducted a repeated cross-sectional survey in English and Spanish of caregiver influenza and SARS-CoV-2 knowledge, attitudes, behaviors, and associated VH among hospitalized children 6 mo-18 yrs at a large pediatric medical institution. Caregivers were enrolled over 3 influenza seasons (S);2019-2020 (S1), 2020-2021 (S2), and 2021-2022 (S3). VH was assessed using the Parent Attitudes about Childhood Vaccines (PACV) survey;PACV score >= 50 denoted VH. Descriptive statistics were used. Results. During 3 influenza seasons, 269/282 (95%), 295/307 (96%), and 384/418 (92%) of approached caregivers were enrolled in S1, S2, and S3 respectively. Most parents (45%) identified as Hispanic/Latino, 35% as White, and 20% as Black/African American. By report, 94% of children in S1, 91% in S2, and 91% in S3 were up-to-date with routine childhood vaccines. Based on PACV score, 13% of parents were VH in 19-20 compared to 17% in 20-21 and 19% in 21-22. Approximately 70% of caregivers gave or planned to give their child the influenza vaccine across seasons. Following the COVID-19 pandemic, caregivers were less likely to believe that the 'flu can be a dangerous infection in children,' and to agree that 'all children over 6 months of age should receive the flu shot every year'. Decreased concern persisted or did not recover during the pandemic (Table 1). Parents were consistently scared of their child getting COVID-19 but fewer (49% versus 38%) were scared of their child getting the SARS-CoV-2 vaccine in S3. More (50% versus 71%) caregivers in S3 were willing to receive the SARS-CoV-2 vaccine themselves and 46% in S2 and 54% of caregivers in S3 had or planned to vaccinate their child against COVID-19 (Table 2). Conclusion. Our results suggest a trend that VH may be increasing. During the COVID-19 pandemic, caregivers of hospitalized children were less concerned about influenza than pre-pandemic. Intention to vaccinate children against COVID-19 remains suboptimal.
ABSTRACT
Background. SARS-CoV-2 vaccine hesitancy (VH) is hindering nationwide vaccination efforts;little is known about caregiver SARS-CoV-2 vaccine acceptance for children. We aimed to identify associations with SARS-CoV-2 VH in caregivers of hospitalized children. Methods. We conducted a prospective cross-sectional survey in English and Spanish of caregiver COVID-19 knowledge, attitudes, behaviors, and associated VH among hospitalized children 6 months - 18 years at a large pediatric medical institution. Parents were approached daily, averaging 4-5 days/week, from 12/8/2020--4/5/2021. VH was assessed using the Parent Attitudes about Childhood Vaccines (PACV) survey;PACV score ≥50 denoted VH. Descriptive statistics and multivariable logistic regression were used. Responses were categorized. Results. 295/307 (96%) of approached caregivers enrolled;79% were ≥ 30 years, 68% were married/ living with a partner, and 57% had at least some college. 36% identified as white, 19% Black, and 46% Hispanic/ Latino. 53% of caregiver children had public insurance. 91% of caregivers self-reported their children were up to date with routine vaccines. 17% of caregivers were vaccine-hesitant overall. 50% of caregivers were willing to receive COVID-19 vaccine themselves. Figure 1 shows intention to vaccinate their child by PACV score. 65% knew someone who was hospitalized for COVID-19. 67% were scared of their child getting COVID-19. However, 49% were scared of their child getting the vaccine, 28% did not want to vaccinate their child and 27% were neutral in the intention to vaccinate their child. Caregivers who did not intend to vaccinate their child were more likely to be Black (27% vs. 16%, p=0.04) and less likely to be Hispanic/ Latino (33% vs. 49%, p=0.02). Table 1 shows attitudes, beliefs, and behaviors surrounding the COVID-19 pandemic and vaccine in caregivers who did or did not intend to vaccinate their child. Figure 1 COVID-19 vaccine uptake by PACV score Table 1 Caregiver attitudes, beliefs, and behaviors surrounding the COVID-19 pandemic and the COVID-19 vaccine Conclusion. The majority of caregivers believe that SARS-CoV-2 vaccine will help control the pandemic, but less than half plan to vaccinate their children. A quarter of caregivers expressed uncertainty regarding the vaccine and therefore may be amenable to education and discussion. COVID-19 VH is different from VH towards routine vaccinations. More research is needed to address COVID-19 specific VH.
ABSTRACT
Background. Influenza vaccine is recommended for all children ≥6 months, yet uptake is suboptimal. We aimed to quantify child influenza vaccine coverage and identify factors associated with influenza vaccine hesitancy (VH) before and during the COVID-19 pandemic. Methods. We conducted a prospective, repeated cross-sectional assessment in English and Spanish of caregiver influenza knowledge, attitudes, behaviors, and associated VH among hospitalized children 6 months through 18 years at a large pediatric medical institution. Caregivers were enrolled 4-5 days per week, between 12/11/2019--1/31/2020 and 12/8/2020--4/5/2021. VH was assessed using the Parent Attitudes about Childhood Vaccines (PACV) survey;PACV score ≥50 denoted VH. Descriptive statistics and multivariable logistic regression were used. Results. During 2019-2020 and 2020-2021 influenza seasons, 269/282 (95%) and 295/307 (96%) of approached caregivers enrolled, respectively. By caregiver report, 94% of children in 2019-2020 and 91% in 2020-2021 were up-to-date with routine childhood vaccines (p=0.13). Specific to influenza vaccine, 73% and 68% of children received or planned to receive influenza vaccine in 2019-2020 and 2020-2021, respectively (p=0.13). Based on PACV score, 13% of parents were VH in 2019-2020 compared with 17% in 2020-2021 (p=0.24;Figure 1). Caregivers who had not/did not intend to vaccinate their children had a higher family income (71% vs. 57% >$30,000, p< 0.01) and were less likely to be Hispanic/ Latino (35% vs. 47%, p=0.02). 77% of caregivers were satisfied with information about influenza vaccine received from healthcare providers. Overall, 36% believed "you can get the flu from the flu shot." In 2020-2021, caregivers were less likely to believe that "flu can be a dangerous infection in children," to be "scared of my child getting the flu" and to agree that "all children over 6 months of age should receive the flu shot every year" (Table 1). Conclusion. During the COVID-19 pandemic, caregivers of hospitalized children were less concerned about influenza than pre-pandemic and misinformation about influenza and influenza vaccine persisted. Increased efforts may be needed to educate caregivers about the importance of influenza immunization during the 2021-22 season.