Parental attitudes in the pediatric emergency department about the COVID-19 vaccine

Jared Schiff; Anita R Schmidt; Phung K Pham; Jocelyn B Pérez; Pia S Pannaraj; Pradip P Chaudhari; Danica B Liberman

doi:10.1016/j.vaccine.2022.10.046

Parental attitudes in the pediatric emergency department about the COVID-19 vaccine

Vaccine. 2022 Nov 28;40(50):7328-7334. doi: 10.1016/j.vaccine.2022.10.046. Epub 2022 Oct 26.

Authors

Jared Schiff¹, Anita R Schmidt², Phung K Pham³, Jocelyn B Pérez⁴, Pia S Pannaraj⁵, Pradip P Chaudhari⁶, Danica B Liberman⁷

Affiliations

¹ Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA. Electronic address: jaschiff@chla.usc.edu.
² Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA. Electronic address: anschmidt@chla.usc.edu.
³ Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA; Division of Behavioral and Organizational Sciences, Claremont Graduate University of the Claremont Colleges, Claremont, CA, USA. Electronic address: ppham@chla.usc.edu.
⁴ Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA. Electronic address: jocperez@chla.usc.edu.
⁵ Division of Infectious Disease, Children's Hospital Los Angeles, Los Angeles, CA, USA; Department of Pediatrics and Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. Electronic address: ppannaraj@chla.usc.edu.
⁶ Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA; Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. Electronic address: pchaudhari@chla.usc.edu.
⁷ Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA; Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. Electronic address: dliberman@chla.usc.edu.

Abstract

Background: COVID-19 vaccinations are now recommended in the United States (U.S.) for children ≥ 6 months old. However, pediatric vaccination rates remain low, particularly in the Hispanic/Latinx population.

Objective: Using the 4C vaccine hesitancy framework (calculation, complacency, confidence, convenience), we examined parental attitudes in the emergency department (ED) towards COVID-19 vaccination, identified dimensions of parental vaccine hesitancy, and assessed parental willingness to have their child receive the COVID-19 vaccine.

Methods: As part of a larger multi-methods study examining influenza vaccine hesitancy, we conducted interviews that included questions about COVID-19 vaccine authorization for children. We used directed content analysis to extract qualitative themes from 3 groups of parents in the ED: Hispanic/Latinx Spanish speaking (HS), Hispanic/Latinx English speaking (HE), non-Hispanic/non-Latinx White English speaking (WE). Themes were triangulated with the Parent Attitudes about Childhood Vaccines (PACV) survey, where higher scores indicate increased vaccine hesitancy.

Results: Factors influencing vaccine hesitancy were mapped to the 4C framework from 58 sets of interviews and PACVs. HE and HS parents, compared to WE parents, had less knowledge about COVID-19 and its vaccine, and more beliefs in COVID-19 vaccine myths. However, both HS and HE parent groups were more inclined to endorse COVID-19 vaccine effectiveness as a reason to have their children vaccinated. HS parents felt that COVID-19 increased their fear of illnesses in general and were worried about confusing COVID-19 with other infections. Median PACV scores of HS (Mdn = 20) and HE (Mdn = 20) parent groups were higher than of WE parents (Mdn = 10), but parental willingness to have their child receive COVID-19 vaccination was similar across groups.

Conclusions: Higher COVID-19 vaccine hesitancy among HS and HE parents compared to WE parents may be attributed to insufficient knowledge about COVID-19, its vaccine, along with COVID-19 vaccine myths. Efforts to provide targeted vaccine education to different populations is warranted.

Keywords: 4C framework; COVID-19; COVID-19 vaccine; Childhood vaccines; PACV; Vaccine hesitancy.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

COVID-19 Vaccines*
COVID-19* / prevention & control
Child
Emergency Service, Hospital
Humans
Infant
Parents
Vaccination

Substances

COVID-19 Vaccines

Grants and funding

UL1 TR001855/TR/NCATS NIH HHS/United States