Department of Pediatrics (DJ Opel), University of Washington School of Medicine and Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Wash.
Adult and Child Consortium for Health Outcomes Research and Delivery Science (A Furniss, JD Rice, C Spina, C Perreira, A Dempsey, and S O'Leary), University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colo.
Acad Pediatr. 2022 Nov-Dec;22(8):1407-1413. doi: 10.1016/j.acap.2022.06.014. Epub 2022 Jul 1.
To understand the influence of a novel infectious disease epidemic on parent general attitudes about childhood vaccines.
We conducted a natural experiment utilizing cross-sectional survey data from parents of infants in Washington and Colorado participating in a larger trial that began on September 27, 2019. At enrollment, parents completed the short version of the Parental Attitudes about Childhood Vaccines (PACV-SF), a validated survey scored from 0 to 4, with higher scores representing more negative attitudes. The exposure variable was onset of the SARS-CoV-2 pandemic in the United States, with the before-period defined as September 27, 2019 to February 28, 2020 and the after-period defined as April 1, 2020-December 10, 2020, with the after-period further separated into proximate (April 1, 2020-July 31, 2020) and distant periods (August 1, 2020-December 10, 2020). The outcome variable was parent negative attitudes about childhood vaccines, defined as a score of ≥2 on the PACV-SF. We estimated the probability of the outcome after (vs before) the exposure using log-binomial regression with generalized estimating equations adjusted for demographic confounding variables.
Among 4562 parents, the risk of negative attitudes was lower immediately after (vs before) SARS-CoV-2 onset (adjusted risk ratio [aRR] = 0.58; 95% confidence interval [CI], 0.36, 0.94; P = .027), but by August-December 2020, the average rate of negative attitudes was 35% higher than during April-July 2020 (aRR: 1.35; 95% CI: 1.13, 1.61; P = .0009).
A reduced risk of negative general vaccine attitudes observed immediately after SARS-CoV-2 onset was quickly attenuated.
了解新型传染病疫情对家长对儿童疫苗总体态度的影响。
我们利用 2019 年 9 月 27 日开始的一项更大试验中参与的华盛顿州和科罗拉多州婴儿父母的横断面调查数据进行了一项自然实验。在入组时，父母完成了儿童疫苗父母态度简短版（PACV-SF）的调查，这是一项经过验证的调查，评分范围为 0 到 4，分数越高表示态度越消极。暴露变量是美国 SARS-CoV-2 大流行的开始，前一时期定义为 2019 年 9 月 27 日至 2020 年 2 月 28 日，后一时期定义为 2020 年 4 月 1 日至 2020 年 12 月 10 日，后一时期进一步分为近端（2020 年 4 月 1 日至 2020 年 7 月 31 日）和远端（2020 年 8 月 1 日至 2020 年 12 月 10 日）。结果变量是父母对儿童疫苗的负面态度，定义为 PACV-SF 评分≥2。我们使用对数二项式回归估计了暴露后（与暴露前相比）的结果发生概率，并使用广义估计方程调整了人口统计学混杂变量。
在 4562 名父母中，SARS-CoV-2 发病后（与发病前相比），负面态度的风险较低（调整风险比[aRR] = 0.58；95%置信区间[CI]，0.36，0.94；P = 0.027），但到 2020 年 8 月至 12 月，负面态度的平均发生率比 2020 年 4 月至 7 月高 35%（aRR：1.35；95%CI：1.13，1.61；P = 0.0009）。
在 SARS-CoV-2 发病后立即观察到的负面一般疫苗态度风险降低很快减弱。
