Intent to Vaccinate Children against COVID-19: Low levels of trust in public health agencies trust across rural communities

Abstract

Background: A COVID-19 vaccination for children is positioned to be a critical resource in the pandemic-prevention effort. However, studies have shown hesitation towards COVID-19 vaccination uptake and a lack of trust in government agencies; putting children at risk for not receiving preventative medical care. The purpose of this study was to determine the association between trust in public health agencies and parental intention to vaccinate their children against COVID-19. Methods: Residents of a Midwestern state who reported being parent/guardian of one or more child, aged <18 living at home, were recruited to participate in a cross-sectional online survey conducted during September-October 2020 (n=238). Participants were asked their level of trust in both state and local public health departments and if they planned on vaccinating their children against COVID-19. Resident geography, rural, suburban, and urban, was categorized using definitions from the Health Resource Services Administration (HRSA) and matched to participant county of residence. Descriptive and binomial logistic regression analyses were conducted to predict probability of vaccine intent for children.Results:. Among participants, 132 (55.5%) reported intention to vaccinate their children against COVID-19. Factors that were found to significantly decrease probability of vaccinating child were being a rural resident and lower level of trust in both state and local public health agencies. Discussion: Results from this study highlight the importance of addressing public health agency mistrust among individuals, regardless of geography, to assure more equitable vaccine delivery. Further, special focus may be needed for those living in more isolated, less populated areas, where a higher level of trust may be needed before parents vaccinate their children.

COVID-19 Vaccine Hesitancy among Economically Marginalized Hispanic Parents of Children under Five Years in the United States

“…This is due in part to the fact that within this lower income sample, there was significant variation, with nearly half the respondents meeting the US government poverty threshold and reporting a high school or lower level of education. Findings that indicated that higher percentages of resistant and unsure parents lived in rural communities as compared to accepting parents are consistent with prior research demonstrating that rural communities have lower vaccination rates for preventable diseases, and this has magnified during the pandemic [ 15 , 16 , 53 ].…”

“…Although vaccination rates for this age group vary by state, to date they are particularly low in border states such as Texas (1.1%), Arizona (2.1%) and New Mexico (2.4%), where persons of Hispanic heritage make up a significant portion of the population [ 14 ]. Moreover, Hispanic families are increasingly moving to rural areas of the US, where they experience higher COVID-19-related death rates and lower vaccination rates [ 15 , 16 ].…”

COVID-19 Pediatric Vaccine Hesitancy among Racially Diverse Parents in the United States

“…Consistent with prior studies on parental hesitancy toward routine pediatric vaccines and emerging data on the current pandemic [8][9][10][18][19][20][21][22][23], bivariate analyses indicated all hypothesized demographic, individual and social determinants were significantly associated with parental intentions to vaccinate their child against COVID-19. Multivariate ordinal logistic regression demonstrated that race/ethnicity (non-Hispanic Asian compared to non-Hispanic White), parental vaccine status, education, financial security, vaccine safety and efficacy concerns, COVID-19 misconceptions and perceived childhood susceptibility to and severity of the disease, community support, and FDA and physician recommendations, accounted for 70.3% of the variance, indicating a goodness-of-fit between the model and parents' plans to vaccinate their child.…”

“…The most consistent predictor of parental COVID-19 vaccine hesitancy in the U.S. is lack of confidence in the safety and effectiveness of the vaccine followed by lack of trust in government and perceptions that children are not susceptible to the disease [8,9,[18][19][20][21][22][23]. Demographic variables have also been associated with parental COVID-19 vaccine acceptance.…”