COVID-19 Pediatric Vaccine Hesitancy among Racially Diverse Parents in the United States

Abstract

On 29 October 2021, the U.S. FDA authorized the Pfizer-BioNTech COVID-19 (SARS-CoV-2) vaccine for emergency use in children ages 5–11 years. Racial/ethnic minorities have born the greatest burden of pediatric COVID-19 infection and hospitalization. Research indicates high prevalence of parental vaccine hesitancy among the general population, underscoring the urgency of understanding how race/ethnicity may influence parents’ decision to vaccinate their children. Two weeks prior to FDA approval, 400 Hispanic and non-Hispanic Asian, Black, and White parents of children 5–10 years participated in an online survey assessing determinants of COVID-19 pediatric vaccine hesitancy. Compared to 31% Black, 45% Hispanic, and 25% White parents, 62% of Asian parents planned to vaccinate their child. Bivariate and multivariate ordinal logistic regression demonstrated race/ethnicity, parental vaccine status, education, financial security, perceived childhood COVID-19 susceptibility and severity, vaccine safety and efficacy concerns, community support, and FDA and physician recommendations accounted for 70.3% of variance for vaccine hesitancy. Findings underscore the importance of multipronged population targeted approaches to increase pediatric COVID-19 vaccine uptake including integrating health science literacy with safety and efficacy messaging, communication efforts tailored to parents who express unwillingness to vaccinate, and interventions developed in partnership with and delivered through existing trusted community coalitions.

Determinants of COVID-19 Vaccine Uptake in Adolescents 12–17 Years Old: Examining Pediatric Vaccine Hesitancy Among Racially Diverse Parents in the United States

“…Among parents who themselves were vaccinated, the unadjusted odds of vaccine uptake for their older child were 14 times higher than unvaccinated parents. Our findings are consistent with previous research reporting that vaccinated parents are more likely than unvaccinated parents to accept the vaccine for their children ( 6 , 8 – 10 , 12 , 16 , 17 , 19 , 21 , 22 ). Further, our data point to the influence of one's larger social context on vaccine acceptance.…”

“…Among our sample, parental COVID-19 misconceptions, general vaccine mistrust, and COVID-19 individualist attitudes were found to decrease the odds of vaccine uptake whereas COVID-19 safety measures and collectivist attitudes improved the odds of vaccine uptake. Previous research has found that parents' misconceptions about COVID-19 transmission, symptoms, and severity, and their general attitudes about pediatric vaccine safety are significant barriers to vaccine acceptance ( 6 , 8 – 11 , 13 – 21 ). Consequently, future research must identify public health measures that are effective in reducing vaccine misconceptions and mistrust while also being sensitive to differences in the influence of these concerns across different racial/ethnic groups of parents.…”

“…By contrast, COVID-19 vaccine uptake among parents and associated health behaviors (e.g., masking, social distancing, etc.) have been associated with pediatric COVID-19 vaccine acceptance ( 6 , 17 , 21 , 22 ). Although collectivist attitudes (emphasizing the needs of the group over the individual) have been found to increase intentions to vaccinate among international parent populations ( 16 , 23 ), recent data from the Kaiser Family Foundation suggest that parents in the U.S. may emphasize personal choice over collective responsibility in their COVID-19 vaccine attitudes ( 6 ).…”

Intent among Parents to Vaccinate Children before Pediatric Vaccine Recommendations, Minnesota and Los Angeles County, California--May-September 2021

“…The factor most strongly associated with vaccination intention for children was parental vaccination status. Recent studies examining COVID-19 vaccination intention, 17,18 including a recent international meta-analysis, 19 also have found that parents vaccinated against COVID-19 are much more likely to have their children vaccinated as well. Studies indicate that parents who are vaccinated against COVID-19 are also more likely to be vaccinated against influenza 20 and give greater weight to physician recommendations.…”

“…Studies indicate that parents who are vaccinated against COVID-19 are also more likely to be vaccinated against influenza 20 and give greater weight to physician recommendations. 17 Certain demographic and socioeconomic factors were associated with intention to vaccinate. Our finding that younger parents were more likely to be undecided or without intention to vaccinate is consistent with other studies as well.…”