A qualitative study examining pediatric clinicians' perceptions of delayed vaccine schedules

Characterizing timeliness of recommended vaccinations among privately-insured children in the United States, 2009-2019

BACKGROUND

The Advisory Committee on Immunization Practices (ACIP) recommends early childhood vaccinations, but knowledge is limited about the magnitude and timing of vaccine delay for each recommended dose on a population level. We sought to characterize longitudinal patient-level patterns of early childhood vaccination schedule adherence.

METHODS

Using the Merative MarketScan Commercial Database (2009-2019), we identified commercially-insured infants who received at least one timely dose of a 2-month recommended vaccine. We categorized the number of recommended vaccines administered on the same date at 2, 4, 6, and 12-15 months of age (grace period: -7, +21 days). A Sankey diagram illustrated the number of vaccines received concomitantly during each age window and depicted transitions to different states over time (e.g., no vaccine delay to vaccine delay). For each vaccine dose, we estimated the cumulative incidence of receipt.

RESULTS

Among 1,239,364 eligible children, 28% of infants aged 4 months and 38% of infants aged 6 months did not receive timely, concomitant administration of all recommended vaccines. The number of timely vaccines received concomitantly and age at receipt varied most for doses recommended during the second year of life. Children with a previously delayed (versus timely) dose consistently experienced longer time to subsequent dose.

CONCLUSIONS

National coverage improved over time for all recommended vaccine doses under study, most notably for measles, mumps, and rubella. However, many children do not receive vaccines on schedule. Interventions to maintain adherence to the recommended schedule are needed early in life.

Parental Vaccine Hesitancy in a COVID-19 World: A Qualitative Study of Midwestern Parents' Decisions Regarding COVID-19 Vaccination for Their Children

Introduction

With the launch of the SARS-CoV-2 (COVID-19) vaccines, a new cohort of people exists who do not consider themselves to be completely vaccine-hesitant, but are specifically COVID-19 vaccine hesitant (CVH). There is a need to learn from CVH parents, to ensure their concerns are addressed, and allow them to comfortably vaccinate their children against the COVID-19 virus.

Methods

Surveys were used to identify CVH parents. Using semistructured interviews, we assessed the attitudes of CVH parents toward COVID-19 vaccination in children. An inductive coding method was used to analyze transcripts and develop themes.

Results

Fourteen parents were interviewed. Seven (50%) had received the COVID-19 vaccine even though they had doubts. Six reported that education about mRNA vaccine production was helpful in deciding to get vaccinated. Parents were reluctant regarding pediatric vaccination due to lack of long-term studies and concerns about adverse impact on childhood development. Personal physicians were the most trusted source of information and direct conversations with them were the most influential, as opposed to public health leaders like the U.S. Centers for Disease Control and Prevention and the National Institutes of Health.

Conclusions

Our findings suggested that physicians are among the most trusted sources of information regarding the COVID-19 vaccine for CVH parents. Rather than use broad public health messaging and advertising to increase rates of vaccination, further investigation into training health professionals on how to counsel CVH patients effectively may be a higher impact area of opportunity to improve vaccine response rates.

Political views and science literacy as indicators of vaccine confidence and COVID-19 concern

Introduction

The distrust, delay and refusal of vaccinations represent serious threats to global public health. As demonstrated by the dramatic worldwide impact of the COVID-19 pandemic, adequate vaccine coverage against infectious diseases is essential towards the preservation and function of virtually every aspect of our society. While the determinants of vaccine hesitancy and pandemic concern have been widely investigated, conflicting evidence exists with regards to their association with education levels and political views.

Methods

This study aimed to investigate whether science literacy levels and standpoint on social and economic matters are associated with different levels of vaccine confidence and COVID-19 concern. An online survey was circulated amongst participants recruited via convenience sampling, and data were analysed using non-parametric statistical tests.

Results

The survey (n = 389) highlighted that participants who studied Science at General Certificate of Secondary Education level have a lower vaccine confidence than those with both lower and higher levels of science education. Participants with neutral/centrist political views expressed lower confidence than those with a libertarian social stance or a left-wing economic stance. A higher concern with the COVID-19 pandemic was associated with lower levels of science education, libertarian social views, and left-wing economic views.

Conclusions

The present study provides novel insight on the educational and political factors associated with vaccine hesitancy and pandemic concern within a British population sample.