Parental COVID-19 vaccine hesitancy and vaccine uptake among children and adolescents in the US: Findings from a prospective national cohort

Objectives Our aim was to measure COVID-19 vaccine uptake among children aged 5-17 years old via parents participating in the CHASING COVID Cohort and identify sociodemographic factors associated with it. Methods In this longitudinal study, parents of school-aged children were asked about their own vaccination status and that of their children at three time points between June 2021-January 2022, along with reasons for vaccinating immediately or delaying vaccinations for their children. Multivariable log binomial models were used to identify correlates of vaccine uptake among children. Results Of the 1,583 children aged 5-17 years, 64.9% were vaccinated. Over 40% of parents of 5-11 year old children who intended to delay vaccinating their child in June 2021 had still not vaccinated them by January 2022, including 30% of the parents who were vaccinated. After adjusting for measured confounders, parents’ vaccination status was associated with higher likelihood of children’s vaccine uptake (age-specific adjusted odds ratios [aORs]: aOR16-17 3.7, 95% CI 2.3, 5.9, aOR12-15 3.7, 95% CI 2.6, 5.3; aOR5-11 10.6, 95% CI 5.4, 20.9). Parents’ education (aOR16-17 1.4, 95% CI 1.1, 1.8, aOR12-15 1.5, 95% CI 1.2, 1.9; aOR5-11 2.1, 95% CI 1.5, 2.9) and worry about others getting infected (aOR5-11 1.4, 95% CI 1.1, 1.6) were also associated with higher vaccine uptake among children. A higher proportion of parents of 5-11 year olds (vs. 12-17 year olds) had concerns about vaccine safety and effectiveness. Conclusion To increase vaccination coverage among young children, vaccination campaigns should focus on both vaccinated and unvaccinated parents and messaging should be specific to the child’s age. ### Competing Interest Statement D Nash, M Robertson, and S Kulkarni declare a grant from Pfizer to their institution (CUNY). D Nash declares consulting fees from AbbVie. ### Clinical Protocols ### Funding Statement Funding for this project is provided by The National Institute of Allergy and Infectious Diseases (NIAID), award number 3UH3AI133675-04S1 (MPIs: D Nash and C Grov), the CUNY Institute for Implementation Science in Population Health ([cunyisph.org][1]) and the COVID-19 Grant Program of the CUNY Graduate School of Public Health and Health Policy, and National Institute of Child Health and Human Development grant P2C HD050924 (Carolina Population Center). The NIH played no role in the production of this manuscript nor necessarily endorses the findings. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The IRB of the City University of New York gave ethical approval for this work. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors. [1]: http://cunyisph.org