Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, USA.
Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA.
Ann Med. 2023 Dec;55(1):2232818. doi: 10.1080/07853890.2023.2232818.
Despite recommendations for COVID-19 primary series completion and booster doses for children and adolescents, coverage has been less than optimal, particularly in some subpopulations. This study explored disparities in childhood/adolescent COVID-19 vaccination, parental intent to vaccinate their children and adolescents, and reasons for non-vaccination in the US.
Using the U.S. Census Bureau's Household Pulse Survey (HPS), we analyzed households with children aged <18 years using data collected from September 14 to November 14, 2022 ( = 44,929). Child and adolescent COVID-19 vaccination coverage (≥1 dose, completed primary series, and booster vaccination) and parental intentions toward vaccination were assessed by sociodemographic characteristics. Factors associated with child and adolescent vaccination coverage were examined using multivariable regression models. Reasons for non-vaccination were assessed overall, by the child's age group and respondent's age group.
Overall, approximately half (50.1%) of children aged < 18 years were vaccinated against COVID-19 (≥1 dose). Completed primary series vaccination was 44.2% among all children aged <18 years. By age group, completed primary series was 13.2% among children <5 years, 43.9% among children 5-11 years, and 63.3% among adolescents 12-17 years. Booster vaccination among those who completed the primary series was 39.1% among children 5-11 years and 55.3% among adolescents 12-17 years. Vaccination coverage differed by race/ethnicity, educational attainment, household income, region, parental COVID-19 vaccination status, prior COVID-19 diagnosis, child's age group, and parental age group. Parental reluctance was highest for children aged <5 years (46.8%). Main reasons for non-vaccination among reluctant parents were concerns about side effects (53.3%), lack of trust in COVID-19 vaccines (48.7%), and the belief that children do not need a COVID-19 vaccine (38.8%).
Disparities in COVID-19 vaccination coverage among children and adolescents continue to exist. Further efforts are needed to increase COVID-19 primary series and booster vaccination and parental confidence in vaccines.
尽管有针对儿童和青少年进行 COVID-19 初级系列接种和加强针接种的建议，但接种覆盖率一直不尽人意，尤其是在某些亚人群中。本研究探讨了美国儿童/青少年 COVID-19 疫苗接种、父母为其子女接种疫苗的意愿以及未接种疫苗的原因方面的差异。
使用美国人口普查局的家庭脉搏调查（HPS），我们分析了年龄在 18 岁以下的儿童的家庭，数据收集时间为 2022 年 9 月 14 日至 11 月 14 日（n=44929）。通过社会人口特征评估儿童和青少年 COVID-19 疫苗接种覆盖率（≥1 剂、完成初级系列接种和加强针接种）和父母对疫苗接种的意愿。使用多变量回归模型检查与儿童和青少年疫苗接种覆盖率相关的因素。总体上以及根据儿童年龄组和受访者年龄组评估了未接种疫苗的原因。
总体而言，大约一半（50.1%）年龄在 18 岁以下的儿童接种了 COVID-19 疫苗（≥1 剂）。所有年龄在 18 岁以下的儿童中，完成初级系列接种的比例为 44.2%。按年龄组划分，<5 岁的儿童中完成初级系列接种的比例为 13.2%，5-11 岁的儿童为 43.9%，12-17 岁的青少年为 63.3%。在完成初级系列接种的人群中，5-11 岁儿童的加强针接种率为 39.1%，12-17 岁青少年的接种率为 55.3%。疫苗接种覆盖率因种族/民族、教育程度、家庭收入、地区、父母 COVID-19 疫苗接种状况、既往 COVID-19 诊断、儿童年龄组和父母年龄组而异。对于年龄<5 岁的儿童，父母的不情愿程度最高（46.8%）。不情愿的父母不接种疫苗的主要原因是担心副作用（53.3%）、对 COVID-19 疫苗缺乏信任（48.7%）以及认为儿童不需要 COVID-19 疫苗（38.8%）。
儿童和青少年 COVID-19 疫苗接种覆盖率方面仍存在差异。需要进一步努力增加 COVID-19 初级系列和加强针接种以及父母对疫苗的信心。
