Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, United States.
Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, United States.
Vaccine. 2022 Jul 30;40(32):4432-4439. doi: 10.1016/j.vaccine.2022.05.089. Epub 2022 Jun 6.
Vaccinating children against COVID-19 protects children's health and can mitigate the spread of the virus to other community members.
The primary objective of this study was to use a socio-ecological perspective to identify multi-level factors associated with US parents' intention to vaccinate their children.
This study used a longitudinal online cohort. Multinomial logistic regression models assessed socio-ecological predictors of negative and uncertain child COVID-19 vaccination intentions compared to positive intentions.
In June 2021, 297 parents were surveyed and 44% reported that they intended to vaccinate their children while 25% expressed uncertainty and 31% did not intend to vaccinate their children. The likelihood of reporting uncertain or negative intention, compared to positive intention to vaccinate their children was higher among parents who had not received a COVID-19 vaccination and those who did not have trusted information sources. Parents who talked to others at least weekly about the COVID-19 vaccine were less likely to endorse uncertain compared to positive vaccine intentions (aRRR: 0.44; 95% CI: 0.20-0.93). A sub-analysis identified that parents had significantly higher odds of intending to vaccinate older children compared to younger children (children ages 16-17 years v. 0-4 years OR: 2.01, 95% CI: 1.05-3.84). An additional sub-analysis assessed the stability of parents' intention to vaccinate their children between March 2021 and June 2021 (N=166). There was transition within each intention group between the study periods; however, symmetry and marginal homogeneity test results indicated that the shift was not statistically significant. Parents expressing uncertainty in March 2021 were the most likely to change their intention, with 24% transitioning to positive intention and 23% to negative intention in June 2021.
Study findings suggest that programs to promote vaccination uptake should be dyadic and work to promote child and parent vaccination. Peer diffusion strategies may be particularly effective at promoting child vaccination uptake among parents expressing uncertainty.
为儿童接种 COVID-19 疫苗可保护儿童健康，并有助于减少病毒在社区其他成员中的传播。
本研究的主要目的是从社会生态的角度出发，确定与美国父母为子女接种疫苗的意愿相关的多层次因素。
本研究使用纵向在线队列。多项逻辑回归模型评估了社会生态因素对负面和不确定儿童 COVID-19 疫苗接种意愿与积极意愿的预测作用。
2021 年 6 月，对 297 名家长进行了调查，44%的家长表示打算为孩子接种疫苗，25%的家长表示不确定，31%的家长不打算为孩子接种疫苗。与积极意愿相比，未接种 COVID-19 疫苗和没有信任信息来源的父母报告不确定或负面接种意愿的可能性更高。每周至少与他人谈论 COVID-19 疫苗的父母不太可能表示不确定与积极的疫苗接种意愿（ARR：0.44；95%CI：0.20-0.93）。一项亚分析发现，与年幼的孩子相比，父母更有可能打算为年龄较大的孩子接种疫苗（16-17 岁的孩子与 0-4 岁的孩子 OR：2.01，95%CI：1.05-3.84）。另一项亚分析评估了父母在 2021 年 3 月至 2021 年 6 月期间为子女接种疫苗的意愿的稳定性（N=166）。在研究期间，每个意愿组内都有转变；然而，对称性和边缘同质性检验结果表明，这种转变没有统计学意义。2021 年 3 月表示不确定的父母最有可能改变他们的意愿，其中 24%在 2021 年 6 月转为积极意愿，23%转为消极意愿。
研究结果表明，促进疫苗接种的项目应该是双边的，并努力促进儿童和家长的疫苗接种。同伴扩散策略可能特别有效地促进对表示不确定的父母的儿童疫苗接种率。
