Looking Ahead: Caregivers’ COVID-19 Vaccination Intention for Children 5 years old and younger

Abstract: Little research has been conducted to examine parents’ intention to vaccinate their young children for COVID19. An online survey with a national U.S. sample of 682 primary caregivers of children under age six assessed variables associated with intention to accept the COVID-19 vaccine for their children from November 13, 2020, to December 8, 2020. 

Caregivers whose child received a recent influenza vaccine, as well as those with previous experience COVID-19, were more likely to express COVID-19 vaccination intention for their young child. Identifying as female was associated with lower COVID-19 vaccination intention, while identifying as Hispanic or Latino was associated with higher intention. Health Belief Model variables of perceived severity of COVID-19 for their child, as well as vaccine confidence, were positive predictors of COVID-19 vaccine intention and mediated the relationship between prior behavior, demographic variables, and intention. The findings highlight the importance of early, proactive COVID-19 vaccination education efforts directed at caregivers with young children. Vaccines for young children will likely become a necessary part of ending the pandemic’s impact in school settings. Operationally, COVID-19 vaccination may also become a part of childhood vaccination schedules. Understanding the beliefs and intentions of caregivers of young children before vaccinations are recommended for children will enable public health officials and medical practitioners to prepare in advance. 

Adherence to Timely Vaccinations in the United States.

Abstract: To estimate 1) the proportion of children not adhering to the Advisory Committee on Immunization Practices (ACIP) recommended early childhood immunization schedule and 2) associations between schedule adherence, sociodemographic characteristics and up-to-date immunization status by 19-35 months of age. Methods: We used 2014 National Immunization Survey (NIS) provider-verified vaccination data to classify vaccination patterns as “recommended” (i.e., in line with ACIP dose- and agespecific recommendations), “alternate” (i.e., in line with either limiting the number of shots per visit or skipping at least one vaccine series) or “unknown/unclassifiable” (i.e., not in-line with ACIP recommendations nor clearly limiting shots per visit or vaccine series). We evaluated predictors of immunization schedule adherence patterns and estimated the association between vaccination patterns and up-to-date status for all ACIP-recommended vaccinations (including rotavirus and hepatitis A vaccines) using Poisson regression. Results: The majority of children’s patterns were classified as “recommended” (63%), with 23% and 14% following alternate or unknown/unclassifiable patterns, respectively; 58% of children were up-to-date with all ACIP-recommended immunizations by 19-35 months. Not being up-to-date was associated with alternate (prevalence ratio [PR] = 4.2, 95% confidence interval [CI] 3.9, 4.5) and unknown/unclassifiable (PR = 2.4, 95% CI 2.2, 2.7) vaccination patterns. Conclusion: Overall high vaccine coverage by 19-35 months of age may miss non-adherence to the recommended immunization schedule in the first 18 months of life, leaving children vulnerable to preventable diseases. With more than one-third of US children not following the ACIP schedule, targeted interventions are needed to minimize vaccine delays and disease susceptibility.