Exploring Hesitancy, Motivations, and Practical Issues for COVID-19 Vaccination Among Vaccine-Hesitant Adopter Parents Using the Increasing Vaccination Model.

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.

Social Processes and COVID-19 Vaccination of Children of Hesitant Mothers.

OBJECTIVE: Investigate relationships between pediatric COVID-19 vaccination and social processes of healthcare provider recommendations and school encouragement to provide insights into social processes that may support pediatric COVID-19 vaccination among hesitant mothers. METHODS: We analyzed survey data from a subsample (n = 509) of vaccine-hesitant mothers to child patients (ages 2 to 17) in regional clinics across Arkansas. Data were collected between September 16th and December 6th, 2022. Full information maximum likelihood multivariable logistic regression was conducted to evaluate associations with pediatric COVID-19 vaccination. RESULTS: Adjusted odds of pediatric COVID-19 vaccination were more than three times greater when a child's healthcare provider recommended vaccination compared to when they did not (aOR = 3.52; 95% CI[2.06, 6.01]). Adjusted odds of pediatric COVID-19 vaccination were 85% greater when a child's school encouraged parents to vaccinate compared to when the school did not (aOR = 1.85; 95% CI[1.13, 3.03]). CONCLUSIONS: For pediatric COVID-19 vaccination, having a personal healthcare provider is not significantly different from having no personal healthcare provider if they do not recommend the child be vaccinated. PRACTICE IMPLICATIONS: Clinical and public health interventions should consider social processes of healthcare provider recommendations and school encouragement.

Understanding HPV Vaccine Hesitancy and What Helped Hesitant Adopter Parents Have Their Children Vaccinated Despite Their Hesitancy.

INTRODUCTION: One out of four parents reported HPV vaccine hesitancy; however, little is known about HPV vaccine-hesitant parents who vaccinate their children (e.g., hesitant adopters). METHOD: We use individual interviews (n = 8) to explore hesitancy and facilitators for overcoming hesitancy among hesitant adopter parents. We drew a priori codes from the Increasing Vaccination Model domains and identified seven emergent secondary themes. RESULTS: Understandable information about safety, side effects, and effectiveness could address HPV vaccine hesitancy. Health care professionals, family, friends, and coworkers were trusted vaccine and vaccination information sources. The study documents the lack of access to HPV vaccines with established health care providers as a barrier to vaccination. DISCUSSION: This is the first study of hesitant adopter parents that expands our understanding of factors driving HPV vaccination among them. Study insights can inform future efforts to increase HPV vaccine uptake among the hesitant.

Reduced Expression of EXTL2, a Member of the Exostosin (EXT) Family of Glycosyltransferases, in Human Embryonic Kidney 293 Cells Results in Longer Heparan Sulfate Chains.

Heparan sulfate proteoglycans are ubiquitously located on cell surfaces and in the extracellular matrices. The negatively charged heparan sulfate chains interact with a multitude of different proteins, thereby influencing a variety of cellular and developmental processes, for example cell adhesion, migration, tissue morphogenesis, and differentiation. The human exostosin (EXT) family of genes contains five members: the heparan sulfate polymerizing enzymes, EXT1 and EXT2, and three EXT-like genes, EXTL1, EXTL2, and EXTL3. EXTL2 has been ascribed activities related to the initiation and termination of heparan sulfate chains. Here we further investigated the role of EXTL2 in heparan sulfate chain elongation by gene silencing and overexpression strategies. We found that siRNA-mediated knockdown of EXTL2 in human embryonic kidney 293 cells resulted in increased chain length, whereas overexpression of EXTL2 in the same cell line had little or no effect on heparan sulfate chain length. To study in more detail the role of EXTL2 in heparan sulfate chain elongation, we tested the ability of the overexpressed protein to catalyze the in vitro incorporation of N-acetylglucosamine and N-acetylgalactosamine to oligosaccharide acceptors resembling unmodified heparan sulfate and chondroitin sulfate precursor molecules. Analysis of the generated products revealed that recombinant EXTL2 showed weak ability to transfer N-acetylgalactosamine to heparan sulfate precursor molecules but also, that EXTL2 exhibited much stronger in vitro N-acetylglucosamine-transferase activity related to elongation of heparan sulfate chains.