University of Nebraska Medical Center, Omaha, Nebraska.
Medical University of South Carolina, Charleston, South Carolina.
Pediatrics. 2023 Nov 1;152(5). doi: 10.1542/peds.2023-062466.
Addressing parental/caregivers' coronavirus disease 2019 (COVID-19) vaccine hesitancy is critical to improving vaccine uptake in children. Common concerns have been previously reported through online surveys, but qualitative data from KII and focus groups may add much-needed context. Our objective was to examine factors impacting pediatric COVID-19 vaccine decision-making in Black, Spanish-speaking, and rural white parents/caregivers to inform the content design of a mobile application to improve pediatric COVID-19 vaccine uptake.
Parents/caregivers of children aged 2 to 17 years from groups disproportionately affected by COVID-19-related vaccine hesitancy (rural-dwelling persons of any race/ethnicity, urban Black persons, and Spanish-speaking persons) were included on the basis of their self-reported vaccine hesitancy and stratified by race/ethnicity. Those expressing vaccine acceptance or refusal participated in KII, and those expressing hesitancy in focus groups. Deidentified transcripts underwent discourse analysis and thematic analysis, both individually and as a collection. Themes were revised until coders reached consensus.
Overall, 36 participants completed the study: 4 vaccine acceptors and 4 refusers via KIIs, and the remaining 28 participated in focus groups. Participants from all focus groups expressed that they would listen to their doctor for information about COVID-19 vaccines. Infertility was a common concern, along with general concerns about vaccines. Vaccine decision-making was informed by the amount of information available to parents/caregivers, including scientific research; possible positive and negative long-term effects; and potential impacts of vaccination on preexisting medical conditions.
Parents/caregivers report numerous addressable vaccine concerns. Our results will inform specific, targeted interventions for improving COVID-19 vaccine confidence.
解决父母/照顾者对 2019 年冠状病毒病（COVID-19）疫苗的犹豫态度对于提高儿童疫苗接种率至关重要。之前通过在线调查已经报道了常见的担忧，但来自 KII 和焦点小组的定性数据可能会增加急需的背景信息。我们的目的是研究影响黑人和西班牙裔以及农村白人父母/照顾者对儿童 COVID-19 疫苗决策的因素，以为提高儿童 COVID-19 疫苗接种率的移动应用程序的内容设计提供信息。
根据自我报告的疫苗犹豫态度和种族/族裔分层，选择受 COVID-19 相关疫苗犹豫情绪影响较大的儿童（任何种族/族裔的农村居民、城市黑人以及讲西班牙语的人）的 2 至 17 岁儿童的父母/照顾者。那些表示接受或拒绝疫苗的人通过 KII 参与，而那些表示犹豫不决的人则通过焦点小组参与。对去识别的转录本进行话语分析和主题分析，个体分析和整体分析。主题不断修订，直到编码员达成共识。
总体而言，共有 36 名参与者完成了这项研究：4 名疫苗接受者和 4 名拒绝者通过 KII 进行，其余 28 名参与者参加了焦点小组。所有焦点小组的参与者都表示，他们会听取医生的意见，以获取有关 COVID-19 疫苗的信息。不孕是一个常见的关注点，同时还有对疫苗的一般担忧。疫苗决策受到父母/照顾者可获得的信息量的影响，包括科学研究；可能的长期积极和消极影响；以及接种疫苗对现有医疗条件的潜在影响。
父母/照顾者报告了许多可解决的疫苗担忧。我们的研究结果将为提高 COVID-19 疫苗信心提供具体的、有针对性的干预措施。
