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Mantina NM, Ngaybe MGB, Zeiders KH, Osman KM, Wilkinson-Lee AM, Landor AM, Hoyt LT. Latinx youth's and parents' covid-19 beliefs, vaccine hesitancy and vaccination rates: Longitudinal associations in a community sample. PLoS One 2024; 19:e0307479. [PMID: 39046951 PMCID: PMC11268593 DOI: 10.1371/journal.pone.0307479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 07/05/2024] [Indexed: 07/27/2024] Open
Abstract
INTRODUCTION The Latinx population has the second highest COVID-19 death rate among racial/ethnic groups in the United States and less than half of Latinx youth aged 5-17 years old completed their COVID-19 primary vaccination series as of September 2022. COVID-19 vaccine misinformation detrimentally impacts vaccination rates. In this study, we examined factors that predicted Latinx youth COVID-19 vaccine hesitancy and vaccination status. METHODS A community-based sample of 290 Latinx parent and adolescent dyads from a Southwestern metropolitan area of the United States who were recruited to complete an online survey at baseline at T1 (August 2020 -March 2021) and one year later. We tested a longitudinal mediation model in which we examined individual and family factors that would predict youth COVID-19 vaccine hesitancy and vaccination status over time. RESULTS Youth's pandemic disbelief (i.e., the belief that the COVID-19 pandemic is a conspiracy or not real) predicted greater youth's COVID-19 vaccine hesitancy, and in turn, a lower likelihood of youth's COVID-19 vaccination. Youth's pandemic disbelief also predicted greater parent's vaccination hesitancy which, in turn, predicted greater youth's vaccination hesitancy and a lower likelihood of COVID-19 vaccination. Parents' pandemic disbelief predicted their own COVID-19 hesitancy, but not youth hesitancy. DISCUSSION Our study findings provide initial evidence that general pandemic disbelief was a significant driver of vaccine hesitancy and vaccination among Latinx families. The study contributes to the limited research investigating COVID-19 vaccination in the Latinx community and among Latinx youth, further aiding how COVID-19 vaccine disparities can be mitigated among racial/ethnic populations.
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Affiliation(s)
- Namoonga M. Mantina
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, United States of America
| | - Maiya G. Block Ngaybe
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, United States of America
| | - Katharine H. Zeiders
- Norton School of Human Ecology, University of Arizona, Tucson, Arizona, United States of America
| | - Kayla M. Osman
- Norton School of Human Ecology, University of Arizona, Tucson, Arizona, United States of America
| | - Ada M. Wilkinson-Lee
- Department of Mexican American Studies, University of Arizona, Tucson, Arizona, United States of America
| | - Antoinette M. Landor
- Department of Human Development and Family Science, University of Missouri, Columbia, Missouri, United States of America
| | - Lindsay T. Hoyt
- Department of Psychology, Fordham University, Bronx, New York, United States of America
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Ryan GW, Askelson NM, Woodworth KR, Lindley MC, Gedlinske A, Parker AM, Gidengil CA, Petersen CA, Scherer AM. Unvaccinated Adolescents' COVID-19 Vaccine Intentions: Implications for Public Health Messaging. J Adolesc Health 2023; 73:679-685. [PMID: 37395695 PMCID: PMC10529916 DOI: 10.1016/j.jadohealth.2023.05.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 04/20/2023] [Accepted: 05/22/2023] [Indexed: 07/04/2023]
Abstract
PURPOSE COVID-19 vaccine uptake remains low for US adolescents and contributes to excess morbidity and mortality. Most research has assessed parental intention to vaccinate their children. We explored differences between vaccine-acceptant and vaccine-hesitant unvaccinated US adolescents using national survey data. METHODS A nonprobability, quota-based sample of adolescents, aged 13-17 years, was recruited through an online survey panel in April 2021. One thousand nine hundred twenty seven adolescents were screened for participation and the final sample included 985 responses. We assessed responses from unvaccinated adolescents (n = 831). Our primary measure was COVID-19 vaccination intent ("vaccine-acceptant" defined as "definitely will" get a COVID-19 vaccine and any other response classified as "vaccine-hesitant") and secondary measures included reasons for intending or not intending to get vaccinated and trusted sources of COVID-19 vaccine information. We calculated descriptive statistics and chi-square tests to explore differences between vaccine-acceptant and vaccine-hesitant adolescents. RESULTS Most (n = 831; 70.9%) adolescents were hesitant, with more hesitancy observed among adolescents with low levels of concern about COVID-19 and high levels of concern about side effects of COVID-19 vaccination. Among vaccine-hesitant adolescents, reasons for not intending to get vaccinated included waiting for safety data and having parents who would make the vaccination decision. Vaccine-hesitant adolescents had a lower number of trusted information sources than vaccine-acceptant adolescents. DISCUSSION Differences identified between vaccine-acceptant and vaccine-hesitant adolescents can inform message content and dissemination. Messages should include accurate, age-appropriate information about side effects and risks of COVID-19 infection. Prioritizing dissemination of these messages through family members, state and local government officials, and healthcare providers may be most effective.
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Affiliation(s)
- Grace W Ryan
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts.
| | - Natoshia M Askelson
- Department of Community and Behavioral Health, University of Iowa, Iowa City, Iowa
| | | | | | - Amber Gedlinske
- Department of Internal Medicine, University of Iowa, Iowa City, Iowa
| | | | - Courtney A Gidengil
- RAND Corporation, Boston, Massachusetts; Division of Infectious Diseases, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Christine A Petersen
- Department of Internal Medicine, University of Iowa, Iowa City, Iowa; Department of Epidemiology, University of Iowa, Iowa City, Iowa
| | - Aaron M Scherer
- Department of Internal Medicine, University of Iowa, Iowa City, Iowa
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3
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Mansfield LN, Choi K, Delgado JR, Macias M, Munoz-Plaza C, Lewin B, Bronstein D, Chang J, Bruxvoort K. Decision-Making about COVID-19 Vaccines among Health Care Workers and Their Adolescent Children. West J Nurs Res 2023; 45:665-673. [PMID: 37096318 PMCID: PMC10280115 DOI: 10.1177/01939459231170981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
Health care workers promote COVID-19 vaccination for adolescent patients, and as parents, may influence their own children to get vaccinated. We conducted virtual, semi-structured qualitative interviews with vaccinated health care workers and their adolescent children to explore their decision-making process for COVID-19 vaccination. In total, 21 health care workers (physicians, nurses, and medical staff) and their adolescent children (N = 17) participated in interviews. The following three themes described parent-adolescent decision-making for COVID-19 vaccination: (1) family anticipation and hesitation about COVID-19 vaccine approval; (2) parents' or adolescents' choice: the decision maker for adolescent COVID-19 vaccination; and (3) leveraging one's vaccination status to encourage others to get vaccinated. Nurses encouraged adolescent autonomy in decisions for COVID-19 vaccination while physicians viewed vaccination as the parent's decision. Health care workers and their adolescent children used role-modeling to motivate unvaccinated peers and may model their decision-making process for adolescent COVID-19 vaccination with their own children to support their patients' and parents' vaccine decisions.
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Affiliation(s)
- Lisa N. Mansfield
- National Clinician Scholars Program,
Division of General Medicine & Health Services Research, Department of Medicine,
David Geffen School of Medicine at UCLA, University of California, Los Angeles, CA,
USA
- School of Nursing, University of North
Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kristen Choi
- Department of Research &
Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
- School of Nursing, University of
California, Los Angeles, CA, USA
- Department of Health Policy and
Management, Fielding School of Public Health, University of California, Los Angeles,
CA, USA
| | - Jeanne R. Delgado
- National Clinician Scholars Program,
Division of General Medicine & Health Services Research, Department of Medicine,
David Geffen School of Medicine at UCLA, University of California, Los Angeles, CA,
USA
- Division of General Pediatrics,
Department of Pediatrics, Children’s Hospital Los Angeles, University of Southern
California Keck School of Medicine, Los Angeles, CA, USA
| | - Mayra Macias
- Department of Research &
Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Corrine Munoz-Plaza
- Department of Research &
Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Bruno Lewin
- Southern California Permanente Medical
Group, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - David Bronstein
- Southern California Permanente Medical
Group, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - John Chang
- Department of Research &
Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Katia Bruxvoort
- Department of Research &
Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
- Department of Epidemiology, School of
Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
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Harris JN, Mauro CM, Morgan TL, de Roche A, Zimet GD, Rosenthal SL. Factors impacting parental uptake of COVID-19 vaccination for U.S. Children ages 5-17. Vaccine 2023; 41:3151-3155. [PMID: 37045680 PMCID: PMC10080272 DOI: 10.1016/j.vaccine.2023.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/27/2023] [Accepted: 04/02/2023] [Indexed: 04/14/2023]
Abstract
COVID-19 vaccination of U.S. children lags behind adult vaccination, but remains critical in mitigating the pandemic. Using a subset of a nationally representative survey, this study examined factors contributing to parental uptake of COVID-19 vaccine for children ages 12-17 and 5-11, stratified by parental COVID-19 vaccination status. Among vaccinated parents, uptake was higher for 12-17-year-olds (78.6%) than 5-11-year-olds (50.7%); only two unvaccinated parents vaccinated their children. Child influenza vaccination was predictive of uptake for both age groups, while side effect concerns remained significant only for younger children. Although parents were more likely to involve adolescents in vaccine decision-making than younger children, this was not predictive of vaccine uptake. These results highlight the importance of addressing the unique and shared concerns parents have regarding COVID-19 vaccination for children of varying ages. Future work should further explore adolescent/child perspectives of involvement in COVID-19 vaccination decision-making to support developmentally appropriate involvement.
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Affiliation(s)
- Julen N Harris
- Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA; NewYork-Presbyterian Hospital, New York, NY, USA
| | - Christine M Mauro
- Department of Biostatistics at the Mailman School of Public Health at Columbia University Irving Medical Center, New York, NY, USA
| | - Tucker L Morgan
- Department of Biostatistics at the Mailman School of Public Health at Columbia University Irving Medical Center, New York, NY, USA
| | - Ariel de Roche
- Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA
| | - Gregory D Zimet
- Division of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Susan L Rosenthal
- Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA; Department of Psychiatry at Vagelos College of Physicians and Surgeons at Columbia University Irving Medical Center, New York, NY, USA.
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English A, Middleman AB. Adolescents, Young Adults, and Vaccine Hesitancy: Who and What Drives the Decision to Vaccinate? Pediatr Clin North Am 2023; 70:283-295. [PMID: 36841596 DOI: 10.1016/j.pcl.2022.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
Although vaccines are important for all age groups, issues of vaccine uptake and vaccine hesitancy have particular salience for the adolescent and young adult age group. This article reviews the importance of vaccination for adolescents and young adults, the variability in uptake of different vaccines, the reasons for vaccine hesitancy for this age group, and the legal framework for consent for vaccination. One important difference between vaccine hesitancy for adolescents and hesitancy for younger children or adults is the unique developmental, clinical, ethical, and legal context in which the decision to vaccinate is made.
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Affiliation(s)
- Abigail English
- Center for Adolescent Health & the Law, PO Box 3795, Chapel Hill, NC 27515, USA; Gillings School of Global Publlic Health, University of North Carolina, Chapel Hill.
| | - Amy B Middleman
- Department of Pediatrics, University of Oklahoma Health Sciences Center, 1200 Children's Avenue, Suite 12200, Oklahoma City, OK 73104, USA
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Delgado JR, Mansfield LN, Bruxvoort K, Macias M, Grotts J, Lewin B, Bronstein D, Munoz-Plaza C, Szilagyi P, Chang J, Choi K. Adolescent Self-Consent for COVID-19 Vaccination: Views of Healthcare Workers and Their Adolescent Children on Vaccination Autonomy. J Adolesc Health 2023; 72:674-681. [PMID: 36775750 PMCID: PMC9916604 DOI: 10.1016/j.jadohealth.2022.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 12/01/2022] [Accepted: 12/15/2022] [Indexed: 02/12/2023]
Abstract
PURPOSE This study explored the perceptions of healthcare worker parents (physicians, nurses, and staff) and their adolescents (aged 12-17 years) on adolescent self-consent to COVID-19 vaccination by applying the concept of positive deviance of those already vaccinated against COVID-19. METHODS We used a qualitative descriptive design to conduct individual, semi-structured interviews with COVID-19-vaccinated healthcare workers in Southern California and their vaccinated adolescent children. Separate interviews were conducted with parents and adolescents from November to December 2021 using digital phone conferencing software. All interviews were recorded and transcribed. Thematic and constant comparative analysis techniques were used to identify relevant themes and subthemes. RESULTS Twenty one healthcare workers (9 nurses, one nurse practitioner, one technologist, and 10 physicians) and their adolescents (N = 17) participated. Three overarching themes were identified to describe participants' perspectives about adolescent self-consent for COVID-19 vaccination: (1) Family values and practices around adolescent vaccination; (2) Differences in parent and adolescent support for vaccine self-consent laws; and (3) Parent and adolescent uncertainty on readiness for vaccine self-consent laws. Adolescents largely supported self-consent while parents supported the policy if they would be able to have a discussion with their adolescent prior to the decision. DISCUSSION Parents and adolescents supported adolescent self-consent for COVID-19 vaccination, with the reservation that adolescents should discuss the decision alongside their parents to exercise their medical autonomy with supportive guidance. Greater adolescent involvement in making decisions and providing self-consent for healthcare, including vaccines, could prepare adolescents to have a greater sense of autonomy over their health and contribute to population health measures.
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Affiliation(s)
- Jeanne R Delgado
- National Clinician Scholars Program, Division of General Medicine & Health Services Research, Department of Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles, California; Division of General Pediatrics, Department of Pediatrics, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, California.
| | - Lisa N Mansfield
- National Clinician Scholars Program, Division of General Medicine & Health Services Research, Department of Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles, California
| | - Katia Bruxvoort
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Mayra Macias
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California
| | - Joseph Grotts
- UCLA School of Nursing, University of California, Los Angeles, California
| | - Bruno Lewin
- Southern California Permanente Medical Group, Kaiser Permanente Southern California, Pasadena, California
| | - David Bronstein
- Southern California Permanente Medical Group, Kaiser Permanente Southern California, Pasadena, California
| | - Corrine Munoz-Plaza
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California
| | - Peter Szilagyi
- Department of Pediatrics, UCLA Mattel Children's Hospital, University of California at Los Angeles, Los Angeles, California
| | - John Chang
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California
| | - Kristen Choi
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California; UCLA School of Nursing, University of California, Los Angeles, California; Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, California
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Ford CA. The Journal of Adolescent Health's Editor-in-Chief's Annual Reflection: A Year of Endurance and Looking Toward the Future. J Adolesc Health 2022; 71:1-3. [PMID: 35718386 PMCID: PMC9212740 DOI: 10.1016/j.jadohealth.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 04/14/2022] [Indexed: 11/24/2022]
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