COVID-19 vaccination in urban American Indian and Alaska Native children: Parental characteristics, beliefs and attitudes associated with vaccine acceptance

Ann Futterman Collier; Krista R Schaefer; Azhar Uddin; Carolyn Noonan; Denise A Dillard; Linda Son-Stone; Spero M Manson; Dedra Buchwald; Richard MacLehose; CONCERTS Collaborative

doi:10.1016/j.jvacx.2023.100406

COVID-19 vaccination in urban American Indian and Alaska Native children: Parental characteristics, beliefs and attitudes associated with vaccine acceptance

Vaccine X. 2023 Nov 14:15:100406. doi: 10.1016/j.jvacx.2023.100406. eCollection 2023 Dec.

Authors

Ann Futterman Collier¹, Krista R Schaefer¹, Azhar Uddin², Carolyn Noonan², Denise A Dillard¹, Linda Son-Stone³, Spero M Manson⁴, Dedra Buchwald², Richard MacLehose⁵; CONCERTS Collaborative

Affiliations

¹ Southcentral Foundation, Anchorage, AK, United States.
² Institute for Research and Education to Advance Community Health, Elson S Floyd College of Medicine, Washington State University, United States.
³ First Nations Community Healthsource, Albuquerque, NM, United States.
⁴ Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Campus, United States.
⁵ Department of Epidemiology and Community Health, University of Minnesota, School of Public Health, United States.

Abstract

Background: Little is known about vaccination rates for American Indian and Alaska Native (AI/AN) parents and their children, or parental decisions in this regard. Improving vaccination rates is a serious concern due to the disproportionate incidence and morbidity of COVID-19 in AI/AN people.

Purpose: Our goal was to describe urban AI/AN parental attributes associated with COVID-19 vaccination of their children.

Methods: Survey participants (n = 572) were ≥18 years of age, had children ≥5 years of age, AI/AN, and seen at one of six urban health organizations serving primarily AI/AN people within the prior year. They were asked about gender, age, education, marital status, perceived stress, trauma history, whether they had received the COVID-19 vaccine, tested positive for COVID-19 in the past, and if their child was vaccinated. They were also asked about 16 vaccine hesitancy reasons.

Results: Parental vaccination rate was 82%, with 59% of their children vaccinated. Parents who vaccinated their children were older, had higher education, lower stress and trauma, and were more likely to be vaccinated compared to parents who did not vaccinate their children. Forty-two percent of parents indicated they would likely vaccinate their unvaccinated child in the future. Sixteen vaccine hesitancy reasons revealed four factors: distrust, inconvenience, lack of concern about the pandemic, and AI/AN concerns. Parents who had no plans to vaccinate their children had the highest vaccine distrust and lack of concern about the pandemic. Parents with greater vaccine distrust and AI/AN specific concern reported significantly greater trauma history and higher levels of education.

Conclusion: Even though vaccination rates for AI/AN parents and children are high, the consequences of COVID-19 for AI/AN people are more severe than for other US populations. Providers should use trauma-informed, trust-building and culturally competent communication when discussing choices about vaccination with AI/AN parents.

Keywords: Alaska Native and American Indian people; COVID-19 vaccination; Children; Parents; Reasons for vaccine hesitancy; Vaccine acceptance.

Abstract

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