Disparities in Delaware Caregiver Beliefs about the COVID-19 Vaccine for their Children

Abstract

Objective: To describe sociodemographic disparities in caregiver beliefs about the COVID-19 vaccine for their children. Methods: This was a cross-sectional study, linking caregiver-reported data to geocoded sociodemographic data from child EHRs. Caregivers of children receiving care in a Delaware pediatric healthcare system were invited to complete a survey about COVID-19 vaccine beliefs from March 19 to April 16, 2021. Results: 1499 caregivers participated (18% Black, 11% Hispanic, 32% public insurance, 12% rural). 54% of caregivers intended to vaccinate their children, while 34% were unsure and 12% would not. Caregivers of younger children (aOR 3.70, CI 2.36-5.79), Black children (aOR 2.11, CI 1.50-2.96), and from disadvantaged communities (aOR 1.59, CI 1.05-2.42) were more likely to be unsure and not vaccinate their children. Caregivers from rural communities were more likely not to vaccinate their children (aOR 2.51, CI 1.56-4.05). Fewer caregivers of younger children, Black children, and from disadvantaged communities believed in the safety or efficacy of the vaccines (p < 0.001), while fewer caregivers of younger children and from rural communities believed in their children's susceptibility to COVID-19 or risk of getting severe disease from COVID-19 (p < 0.05). While the majority (72%) of caregivers were influenced by health experts, fewer from communities of color and disadvantaged communities were (p<0.001). Conclusions: Caregivers of younger children and from communities of color, rural communities, and disadvantaged communities in Delaware expressed more COVID-19 vaccine hesitancy. Policy implications: This study explores beliefs of different communities in Delaware, which are important to tailoring public health messaging and strategies to increase vaccine uptake in these communities.

Intravenous iron infusions in pediatric patients: A retrospective review of efficacy and safety

“…Future analysis could explore access barriers such as issues with transportation, finding child care for patient siblings, and parents who are unable to take time off from work. [14][15][16] Finally, the presence of unclear IDA etiologies, such as those with complex or multiple diagnoses, made it difficult to determine the factors that contributed most to the IDA, such as a patient who has menorrhagia in the setting of inadequate dietary intake with an underlying diagnosis of von Willebrand disease. This made it difficult to subcategorize patients to determine whether IV iron supplementation is best for a certain IDA etiology compared to others.…”

“…Future analysis could explore access barriers such as issues with transportation, finding child care for patient siblings, and parents who are unable to take time off from work. 14–16…”

An Informed Approach to Vaccine Hesitancy and Uptake in Children

“…17 There are also significant sociodemographic disparities in intention to vaccinate, with caregivers of Black children and from rural and disadvantaged neighborhoods being more hesitant to vaccinate their child against COVID-19. 18 Furthermore, different vaccines engender hesitance in different populations. For example, people who refuse the MMR vaccine are not the same as the ones refusing the COVID-19 vaccine, and the principles impacting this decision are different.…”

“…Many studies have demonstrated the importance of the trusted provider's recommendation on the immunization decision. 18 Providers should work hard to establish rapport, trust, and a therapeutic alliance that is not solely focused on the immunization decision, but the whole patient. Families want providers to listen carefully, respectfully, and non-judgmentally to their concerns, and providers should elicit the reasons and supporting evidence for these concerns.…”

Community Partnership to Co-Develop an Intervention to Promote Equitable Uptake of the COVID-19 Vaccine Among Pediatric Populations

“…8,9 Prior work highlighted that caregivers of Black youth and youth from socioeconomically disadvantaged communities were less likely to intend to vaccinate their child against COVID-19 and viewed the vaccine as less safe and effective. [10][11][12] Prior work also demonstrated the importance of who communicates with families about the COVID-19 vaccine, with parents of all sociodemographic backgrounds viewing their child's pediatrician as the most trusted source of information. 11,12 Finally, lower digital literacy and language barriers may make it difficult for families to schedule appointments to vaccinate their children against COVID-19.…”