Highlights About two thirds of caregivers intend to vaccinate their children against COVID-19. Most common reason for acceptance was to protect the child. Most common reason for refusal was the vaccine’s novelty. Child age, chronic illness, vaccination history affects willingness. Caregiver gender, vaccination history, concern about infection affect willingness.

for the International COVID-19 Parental Attitude Study (COVIPAS) Group* Objectives To determine factors associated with parents who plan to vaccinate their children against influenza next year, especially those who did not vaccinate against influenza last year using a global survey. Study design A survey of caregivers accompanying their children aged 1-19 years old in 17 pediatric emergency departments in 6 countries at the peak of the coronavirus disease 2019 (COVID-19) pandemic. Anonymous online survey included caregiver and child demographic information, vaccination history and future intentions, and concern about the child and caregiver having COVID-19 at the time of emergency department visit. Results Of 2422 surveys, 1314 (54.2%) caregivers stated they plan to vaccinate their child against influenza next year, an increase of 15.8% from the previous year. Of 1459 caregivers who did not vaccinate their children last year, 418 (28.6%) plan to do so next year. Factors predicting willingness to change and vaccinate included child's up-todate vaccination status (aOR 2.03, 95% CI 1.29-3.32, P = .003); caregivers' influenza vaccine history (aOR 3.26, 95% CI 2.41-4.40, P < .010), and level of concern their child had COVID-19 (aOR 1.09, 95% CI 1.01-1.17, P = .022). Conclusions Changes in risk perception due to COVID-19, and previous vaccination, may serve to influence decision-making among caregivers regarding influenza vaccination in the coming season. To promote influenza vaccination among children, public health programs can leverage this information.

Purpose To determine predictors associated with caregivers’ willingness to accept an accelerated regulatory process for Coronavirus disease 2019 (COVID-19) vaccine development. Methods An international cross-sectional survey of 2557 caregivers arriving with their children to 17 pediatric Emergency Departments (ED) across six countries from March 26 to June 30, 2020. Caregivers were asked to select one of four choices they agreed with the most regarding a proposed COVID-19 vaccine approval process, in addition to questions regarding demographics, the ED visit, and attitudes about COVID-19. Univariate analyses were conducted using the Mann-Whitney test for comparing non-normal continuous variables, independent t-test for comparing normally distributed continuous variables, and Chi-square or Fisher’s exact test for categorical variables. Variables of interest subsequently underwent a multivariable logistic regression analysis to determine independent factors associated with caregivers’ willingness to accept abridged COVID-19 vaccine development. A p-value less than 0.05 was considered significant. Findings Almost half (1101/2557; 43%) of caregivers reported that they are willing to accept less rigorous testing and post-research approval for a new COVID-19 vaccine. Independent factors associated with willingness to expedite COVID-19 vaccine research included children that were up-to-date on their vaccination schedule (Odds Ratio (OR) = 1.72, 95% Confidence Interval (CI) = 1.29-2.31), caregivers concerned that they had COVID-19 at the time of survey completion in the ED (OR = 1.1, 95% CI 1.05-1.16), and caregivers that intend to vaccinate their children against COVID-19 if a vaccine becomes available (OR = 1.84, 95% CI 1.54-2.21). Mothers completing the survey were less likely to approve changes in the vaccine development process (OR = 0.64, 95% CI = 0.53-0.78). Implications Less than half of caregivers in a global sample are willing to accept abbreviated vaccine testing during the COVID-19 pandemic. As part of an effort to increase acceptance and uptake of the new vaccine, especially in order to protect children, public health strategies and individual providers should understand caregivers’ attitudes towards approval of the vaccine and consult them appropriately.

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Early-onset epileptic encephalopathy (EE) and combined developmental and epileptic encephalopathies (DEE) are clinically and genetically heterogeneous severely devastating conditions. Recent studies emphasized de novo variants as major underlying cause suggesting a generally low-recurrence risk. In order to better understand the full genetic landscape of EE and DEE, we performed high-resolution chromosomal microarray analysis in combination with whole-exome sequencing in 63 deeply phenotyped independent patients. After bioinformatic filtering for rare variants, diagnostic yield was improved for recessive disorders by manual data curation as well as molecular modeling of missense variants and untargeted plasma-metabolomics in selected patients. In total, we yielded a diagnosis in ∼42% of cases with causative copy number variants in 6 patients (∼10%) and causative sequence variants in 16 established disease genes in 20 patients (∼32%), including compound heterozygosity for causative sequence and copy number variants in one patient. In total, 38% of diagnosed cases were caused by recessive genes, of which two cases escaped automatic calling due to one allele occurring de novo. Notably, we found the recessive gene SPATA5 causative in as much as 3% of our cohort, indicating that it may have been underdiagnosed in previous studies. We further support candidacy for neurodevelopmental disorders of four previously described genes ( PIK3AP1 , GTF3C3, UFC1 , and WRAP53 ), three of which also followed a recessive inheritance pattern. Our results therefore confirm the importance of de novo causative gene variants in EE/DEE, but additionally illustrate the major role of mostly compound heterozygous or hemizygous recessive inheritance and consequently high-recurrence risk.